Health Advantage Plus

Icici Lombard General Insurance

ICICI Lombard is a joint venture between ICICI Bank Limited, which is India’s second largest bank and Fairfax Financial Holdings Limited, a Canada based diversified financial services company. Another policy that they have come up with is the Health Advantage Plus. The FEATURES of this plan are as under:

· This is a health cover primarily for the benefit of senior citizens

· It covers OPD expenses such as diagnostic tests, dental treatment, medical bills, ambulance charges, etc

· Pre-existing illnesses/diseases covered after 2 years of continuous renewal with the company

· Maternity expenses can be covered under OPD expenses up to the OPD sum insured

· Medical expenses incurred as in inpatient during hospitalization for more than 24 hours including room charges, doctor’s/surgeon’s fee, medicine bills, etc

· Medical expenses incurred 30 days prior and 60 days post hospitalization

· This policy also covers hospitalization in case of Swine Flu/H1N1 influenza

· A maximum of 2 adults can be covered under one policy

· The following advanced treatments do not need 24-hour hospitalization but are covered under this policy:

· Cataract limited to Rs.20000 per eye

· Kidney stone removal

· Tonsillectomy

· Eye surgery

· Dialysis

· Dilatation and currettage

· Chemotherapy

· Radiotherapy

· Coronary angiography

· Cardiac catheterization

· OPD cover for room, boarding expenses, nursing expenses, expenses related to dental treatment, surgeon, medical practitioner, consultants, specialist’s fee, anesthesia, blood, oxygen, operation theater charges, surgical consumables, medicines and drugs, diagnostic material and x-ray, cost of pacemaker, cost of artificial limbs, external medical aids

The EXCLUSIONS to this policy are:

Exclusions for the first 30 days:

· Any illness contracted within 30 days from the inception of the policy, except those that are incurred as a result of an accident

Exclusions valid for the first 2 years:

Treatments of the diseases/ailments/illnesses mentioned below:

· Cataract

· Benign prostatic hypertrophy

· Myomectomy, hysterectomy unless due to malignancy

· Hernia, hydrocele

· Fistula in anus, piles

· Arthritis, gout, rheumatism

· Joint replacement unless due to accident

· Sinusitis and related disorders

· Stone in the urinary and biliary systems

· Dilatation and curretage

· Skin and all internal tumors/nodules/cysts of any kind including breast lumps unless malignant, adenoids/hemorrhoids

· Dialysis required for chronical renal failure

· Surgery on tonsils, adenoids, sinusitis

· Gastric and duodenal ulcers

· Deviated nasal septum

Permanent exclusions:

· Any illness/disease/injury/pre-existing disease before the inception of the policy

· Non-allopathic treatment, pregnancy and childbirth related complications, cosmetic aesthetic and obesity related treatment

· Expenses arising from HIV or AIDS and related diseases, use or misuse of liquor, intoxicating substances or drugs as well as intentional self injury

· War, riots, strike, nuclear weapon, induced treatment

Exclusions for OPD:

· Suicide or self inflicted injury

· Alcohol or drug abuse

· War, riots, nuclear related hospitalization

· Non-allopathic treatment, experimental and unproven treatment

· Expenses arising from HIV or AIDS and related diseases, use or misuse of liquor, intoxicating substances or drugs as well as intentional self injury


· People between the age of 5 and 65 years can be covered under this policy

· The proposer should be above the age of 18 years

· The policy can be renewed up to a maximum age of 70 years


A service tax of 10.3% will be levied on all the premium amounts.

The premiums paid towards these health insurance plans are tax exempted under section 80D of the Income Tax Act.

ICICI Lombard health insurances can also be bought online from or they can be contacted on their toll free number 1800-209-8888

The POSITIVES of buying an insurance policy from ICICI Lombard are many, some of them being:

· Cashless claim facility

· Treatment can be taken from 3500+ network hospitals

· Arrangements for in-house health claim processing

· In-house wellness team

· No sub-limits on room rent, doctor fees, hospital charges or any disease, except cataract where Rs.20000 per eye is allowable

· No co-payments for any disease or any hospitalization expenses

· No health check up till the age of 55 years

· Free health check up coupon for any one insured family member for the policy period

· Buy the policies online and pay the premium in EMIs without any extra charge subject to a minimum annual premium of Rs.1500

· Expenses for hospitalization also covered for terrorist activities

· A cumulative bonus of 5% is added to the sum insured for every claim free year subject to a maximum of 50%

Leave a Comment

Your email address will not be published. Required fields are marked *