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ICICI Lombard Health AdvantEDGE Health Insurance

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ICICI Lombard Health Insurance
Health AdvantEDGE
Cashless Approval TAT2 hr Cashless Claim Processing
Claim Settlement Ratio99.70%
Network Hospitals7,500+
Pre-existing Disease Waiting Period2 year
Special BenefitsAnywhere Cashless
Starting Premium for Rs. 5 lakh SIRs. 581/month

About ICICI Lombard Health AdvantEDGE Health Insurance

With rising medical expenses and lifestyle changes, having health insurance has become an absolute must. With health insurance plans, you can get quality treatment without worrying about medical expenses. ICICI Health AdvantEdge is a popular health insurance plan that ICICI Lombard offers to cater to the varied health insurance needs of policyholders. Scroll through the section below to learn all about the ICICI Health AdvantEdge Plan.

ICICI Health AdvantEdge Health Insurance Plan At a Glance:

Coverage

Individual and Floater

Riders

Befit Cover, Daily Hospital Cash, Critical Illness Cover, Convalescence Add-on

Variants

N/A

Key features

Restoration benefit, Health check-ups, Flexible sum insured, etc

Inclusion

AYUSH treatment, Maternity expenses, Day care procedures, etc

Exclusion

Preexisting conditions, Consumables, War or Hostility, etc

Key Features of ICICI Health AdvantEdge

Listed below are some of the key features of the Health AdvantEdge Insurance plan offered by ICICI Lombard health insurance:

  • Restore Benefit: The ICICI Health AdvantEdge plan provides automatic restoration of the sum insured. This means that if the sum insured gets exhausted after you have raised a health insurance claim, then the sum insured will get recharged instantly.
  • Guaranteed Cumulative Bonus: The ICICI Health AdvantEdge policy offers a guaranteed cumulative bonus if no claim has been made in a given year. This guaranteed cumulative bonus is 20% of the sum insured which can go up to 100%.
  • Health Check-up: The ICICI Health AdvantEdge policy provides coverage for health check-ups as mentioned in the policy documents.
  • Option to Choose Sum Insured: Policyholders buying this policy can choose a sum insured between Rs. 5 lakhs to Rs. 3 crores. The policyholders are free to choose the sum insured that best suits their budget.
  • Maternity Expenses: The ICICI Health AdvantEdge also provides optional coverage for expenses related to maternity. It includes coverage for newborn baby as well.
  • Optional Benefits: With the ICICI Health AdvantEdge, policyholders can also get optional benefits such as domestic air ambulance, OPD for mental and dental treatment, maternity cover, and newborn baby cover.

Eligibility Criteria to Buy ICICI Health AdvantEdge Policy

The eligibility criteria to buy the ICICI Health AdvantEdge policy are as follows:

Parametres

Eligibility Criteria

Minimum entry age

18 years

Maximum entry age

65 years

Sum Insured

Rs. 5 lakhs - Rs. 3 crores

Policy tenure

1 year

Benefits of Buying ICICI Health AdvantEdge Policy

Some of the benefits of buying the ICICI Health AdvantEdge Policy are listed below:

  • Value Added Services: The ICICI Health AdvantEdge policy offers a range of value-added services like health rewards, doctor appointments, doctor on call, pharmacy, telephonic consultations, etc.
  • No Medical Test: There is no medical test required for policyholders up to 45 years of age. This reduces the hassle of undergoing medical tests for buying the ICICI Health AdvantEdge.
  • Lifelong Renewability: The ICICI Health AdvantEdge policy has the option of lifelong renewability. This means that if the policy term is over, then you can renew it for a lifetime.
  • Domiciliary Hospitalisation: The ICICI Health AdvantEdge policy also provides coverage for domiciliary hospitalisation. Thus, if the policyholder is getting treated at home instead of a hospital, then the relevant expenses will be covered.
  • Personal Accident Cover: If the policyholder meets an unfortunate death or suffers permanent disability due to an accident, then the Personal Accident Cover benefit is given up to the sum insured.
  • Critical Illness Cover: After the waiting period for critical illness is completed, the ICICI Health AdvantEdge offers coverage for up to 20 critical illnesses, as listed on the policy document. Some of the critical illness covered includes anemia, kidney failure, heart failure, and a few more.

Inclusions of ICICI Health AdvantEdge Health Insurance Policy

Listed below are the common inclusions of the ICICI Health AdvantEdge health insurance plan:

  • Room Rent Cover: This policy offers room rent cover up to the sum insured. The ICU expenses are also covered up to the sum insured.
  • Pre-hospitalisation and Post-hospitalisation Expenses: The medical expenses incurred before the hospitalisation is covered for up to 60 days. And all the post-hospitalisation is covered for up to 180 days.
  • Domiciliary Hospitalisation: Domiciliary treatment expenses are covered up to the sum insured.
  • No-Claim Bonus: For every no-claim-free year, no claim bonus is paid out which is 20% of the sum insured.
  • Daily Hospital Cash: It is the cash amount that is paid out for the daily expenses incurred after getting hospitalized.
  • Maternity Cover: The maternity cover is 10% of the sum insured and goes up to Rs. 10 lakhs.
  • Ayush Treatment: Under this, the plan offers coverage for AYUSH treatment up to the sum insured.
  • Animal Bite: Coverage for animal bites is covered under this plan. The coverage offered is up to the sum insured.

Exclusions of ICICI Health AdvantEdge Health Insurance Plan

Listed below are the exclusions of ICICI Health AdvantEdge policy:

  • Any injury due to a breach of law
  • Any injury due to involvement in sports activities
  • Cosmetic or plastic surgery
  • Coverage for AIDS
  • Coverage for rest cure or rehabilitation therapies
  • Weight-related treatment
  • Change of gender treatment

Riders Available with the ICICI Health AdvantEdge Health Insurance Plans

Policyholders can include a number of riders to their ICICI Health AdvantEdge Health Insurance Plan such as the following:

  • Critical Illness Cover: This add-on provides coverage for critical illness at additional premiums.
  • Hospital Cash Cover: For your daily stay in the hospital, this add-on provides cash benefits.
  • Convalescence Add-on: If you are hospitalised for consecutive days, then this add-on provides cash benefits up to a specific limit.
  • Befit Cover: This cover provides coverage for OPD treatments on a cashless basis.

How to Buy the ICICI Health AdvantEdge Plan with InsuranceDekho?

Listed below are the steps you need to follow to buy the ICICI Health AdvantEdge Plan:

  • Visit the “Health Insurance” section on the official InsuranceDekho website.
  • Choose "ICICI Health Insurance" from the list of health insurance companies.
  • Then, select "Health AdvantEdge" from the available health insurance plans.
  • Read the policy documents carefully
  • Upload all the necessary documents to complete the KYC process
  • After finishing the KYC process, pay the premium online
  • Finally, you will receive the policy document in your registered email

Documents Required to Buy ICICI Health AdvantEdge Plan

Some of the documents essential to buy the ICICI Health AdvantEdge Plan are as follows:

  • Aadhaar card
  • Pan card
  • Income proof
  • Bank passbook
  • Previous medical reports
  • Copy of pre-existing medical conditions
  • Nominee details

Claim Process of ICICI Health AdvantEdge Insurance Plan

The claim for the ICICI Health AdvantEdge Health Insurance Plan can be settled in two ways, either through a cashless process or a reimbursement process. In the cashless process, once the policyholder raises a claim request, the medical expenses will be then directly settled by the insurance company. However, in reimbursement claims, the policyholder will have to spend for the medical expenses from their own pocket which the insurer will later reimburse.

Cashless Claim Process

  • ICICI Health Insurance has tie-ups with a number of network hospitals, so locate a nearby hospital
  • Then, full out the pre-authorisation form and submit all the documents like health insurance copy, medical expenses copy, etc
  • The TPA assigned at the network hospital will then send all the documents to the insurer for approval
  • Once, the insurer has approved all the documents and claim request, the claim request will directly get settled

Reimbursement Claim Process

  • First, locate a nearby hospital and get started with the medical treatment
  • Then, fill out the claim form and send complete details of the medical expenses to the insurance company
  • After verification, the insurance company will approve the claim request
  • Once the claim request is approved, you will receive reimbursement for the total medical expenses incurred

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4280 ICICI Lombard Cashless Network Hospitals in India

Claim Process at ICICI Lombard Health Insurance

  • Network Hospital
  • Non-Network Hospital
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 1-2 days prior to admission.
  • 3

    Claim Processing

    Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
  • 4

    Claim Settlement

    Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 1-2 days prior to admission.
  • 3

    Claim Processing

    Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
  • 4

    Claim Settlement

    Once your request for reimbursement of expenses is approved, the claim will be settled.

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