ICICI Lombard Elevate Health Insurance Custom Review

ICICI Lombard Elevate is one of the newest health insurance policies they offer. As a flagship plan from the stable of ICICI Lombard, the policy comes with a host of features, such as an unlimited sum assured, maternity cover, Infinite Cumulative bonus, etc. They also have several riders and add-ons that enhance the coverage to meet your needs. But, is this truly the right plan for you? Or can you get a better health insurance plan suited to your needs? Let’s find out now.

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Overview: ICICI Lombard Elevate Plan Review

ICICI Lombard Elevate: Brief Overview

Founded in 2001 as a joint venture between ICICI Bank and Canada-based Fairfax Holdings, ICICI Lombard is one of India’s largest general insurers with a broad suite of financial products. As a health insurance provider, the brand is known for its  “Anywhere Cashless” feature that enables cashless claims even at non-network hospitals. Considering that the insurer has been in the industry for several years now, expectations are high that this insurer will reflect the data of a credible provider. However, despite being considered one of the leading insurance companies in the market, the insurer doesn’t fare well across the credibility metrics. Here’s a quick look at them.

While the complaint volume seems to be lower than the industry average, it is still higher than other veterans in the industry, such as HDFC ERGO or Bajaj Allianz, whose complaint volumes are 7 and 3, respectively.

The claim settlement ratio is also significantly lower than the industry average, which is a cause for concern. However, we hope that the insurer does better in the coming years.

Coming to the policy itself, here’s a brief overview of the ICICI Elevate health insurance plan:

Should You Buy Elevate from ICICI Lombard?

1) ICICI Lombard as an Insurer

ICICI Lombard is one of India’s well-established general insurers, traditionally known for its strong presence in the motor, travel, and home insurance segments. In recent years, however, the company has made a concerted push into the health insurance space, operating at a significant scale and actively working to expand its footprint in this segment. While it may not yet be the top name in health insurance, ICICI Lombard has steadily built a reputation for offering flexible products like Elevate and introducing industry-first features that cater to a wide range of customer segments. In this article, we’ll take a closer look at the ICICI Lombard Elevate Health Insurance plan to see if it’s a good policy for you.

2) ICICI Lombard Elevate Comprehensive Review

In-Built Features of ICICI Elevate

ICICI Elevate is the flagship health insurance plan from ICICI Lombard. This plan was launched only last year. However, it is already making strides in the industry, thanks to its good set of features, low restrictions, and unique add-ons.

Here are the inbuilt features of the Elevate policy, excluding any optional add-ons:

• Hospitalization Coverage
  Covers inpatient hospitalization expenses, including room rent, nursing charges, doctor’s fees, surgery, ICU charges, and medical consumables.
• Pre- and Post-Hospitalization Expenses
  Medical expenses incurred before and after hospitalization are covered, up to 90 days before admission and 180 days after discharge, depending on the variant.
• Day Care Procedures
  Covers medical procedures that don’t require 24-hour hospitalization due to advanced technology, such as cataract surgery or dialysis.
• Domiciliary Hospitalization
  Covers treatment taken at home for illnesses or injuries that would otherwise require hospitalization, provided the patient cannot be moved to a hospital due to medical reasons or lack of bed availability.
• AYUSH Treatment
  Expenses incurred for inpatient treatment under Ayurveda, Yoga, Unani, Siddha, and Homeopathy systems of medicine are covered as part of the policy up to the sum insured.
• Emergency Road Ambulance Cover
  Covers the cost of road ambulance services used for transporting the insured to the hospital during an emergency.
• Organ Donor Expenses
  Medical expenses related to the harvesting of an organ for transplantation into the insured are covered, excluding costs related to the donor’s stay beyond surgery.
• No Claim Bonus (NCB)
  20% at the end of each Policy Year, irrespective of a claim being initiated in the Policy Year, provided that the Policy has been continuously renewed with the Company up to a maximum of 100% of the Annual Sum Insured. Even in the event of a Claim, under the Policy, the credited Loyalty bonus will not be reduced.
• Restoration of Sum Insured
  If the base sum insured and any accrued bonus are exhausted in a policy year, the policy automatically refills the base sum insured once to cover future claims for any illness. This is called the Reset Benefit.
• Modern Treatment Coverage
  High-end treatments such as robotic surgeries, stem cell therapy, and other advanced procedures are covered up to the sum assured.
• Digital Wellness and Health Management Tools
  Access to health tracking, wellness programs, digital consultations, and health record management through the insurer’s app or online platform.

Add-Ons/Riders Available in ICICI Elevate

ICICI Elevate comes with several add-ons and riders that truly make the health insurance policy your own. Here is the complete list of riders that they offer:

• Convalescence Benefit
  A lump sum is paid if the insured is hospitalized for a prolonged period (typically more than 10 consecutive days). This helps the policyholder recover lost income or manage additional costs after hospitalization.
• Compassionate Visit
  It covers an immediate family member's travel and accommodation expenses to visit the insured if the latter is hospitalized for an extended period with a critical illness or serious condition. It ensures emotional support during difficult times.
• Maternity Expenses
  This policy provides coverage for medical expenses related to childbirth, including prenatal and postnatal care, delivery (normal or cesarean), and sometimes newborn care. However, do note that there is a sub-limit of 10% of the cover amount up to ₹1 lakh, and it covers only up to 3 deliveries.
• Newborn Baby Cover
  This policy offers medical coverage for a newborn baby from day 1 up to a certain period (generally 90 days), including treatment for congenital defects or hospitalization needs. After this, the child must be added to the base policy for continued coverage.
• Bariatric Surgery Cover
  Covers expenses related to weight-loss surgery if it's medically necessary, such as for morbid obesity that leads to other health complications. Cosmetic or elective bariatric procedures are typically excluded.
• Psychiatric Illness Cover
  Provides inpatient treatment coverage for psychiatric or mental health conditions. This ensures access to specialized care and hospitalization if needed for mental wellness.
• Advanced Treatments Cover
  This policy includes coverage for high-end and modern medical procedures such as robotic surgeries, stem cell therapy, or proton beam therapy. Due to their high cost and specialized nature, these treatments are often excluded from regular policies.
• OPD Cover
  Covers expenses for outpatient consultations, diagnostics, and prescribed medicines without the need for hospitalization. This helps manage regular healthcare expenses.
• Accidental Death Cover
  Pays an additional sum insured if the insured dies due to an accident. This benefit is over and above the base sum insured and supports dependents financially in case of an accidental demise.
• Permanent Total Disability Cover
  Provides a lump sum payout if the insured suffers from a permanent and total loss of limbs, eyesight, or other critical body parts due to an accident, rendering them unable to earn a livelihood.
• Permanent Partial Disability Cover
  Pays a percentage of the sum insured based on the nature and extent of partial disability suffered due to an accident, such as loss of a finger or partial hearing.
• Temporary Total Disability Cover
  Offers weekly income replacement if the insured is temporarily unable to work due to an injury or illness. Payments continue for a fixed period or until recovery, whichever is earlier.
• Critical Illness Cover
  Provides a lump sum benefit upon diagnosis of any listed critical illness, such as cancer, heart attack, stroke, or kidney failure. This amount can be used for treatment, lifestyle adjustments, or income replacement.
• Cancer Cover
  It specifically covers the diagnosis and treatment of cancer across different stages. The payout may differ for early-stage and major-stage cancers, and it ensures financial support through the treatment journey.
• Cardiac Cover
  It covers expenses or provides a lump sum benefit for diagnosing or treating heart-related conditions such as heart attack, coronary artery disease, or bypass surgery.
• Organ Donor Expenses
  Covers medical and surgical expenses related to harvesting an organ from a donor for transplant into the insured. It includes the cost of the donor’s hospitalization and surgery.
• Personal Accident Cover
  A broader rider that includes benefits for accidental death, permanent and partial disabilities, and sometimes temporary disability. It offers comprehensive financial protection in case of accidental injuries.
• Waiver of Premium
  Suppose the policyholder suffers a critical illness or disability. In that case, this add-on ensures that future premiums are waived while the policy remains active, removing the financial burden during tough times.
• Second Medical Opinion
  It allows the insured to consult another qualified doctor or specialist for a second opinion in case of serious illnesses or surgical recommendations. This helps ensure confidence in treatment decisions.
• Air Ambulance Cover
  It covers the cost of transporting the insured by air ambulance to the nearest hospital equipped to handle their condition. This is helpful in emergencies where ground transport is not viable.

Benefits and Drawbacks of ICICI Elevate

Here are some benefits and drawbacks of the ICICI Lombard Elevate Health Insurance Plan:

Benefits:

• Coverage for Surrogate Mother and Oocyte Donor
  One of the standout features of the ICICI Lombard Elevate plan is its inclusion of expenses related to surrogate mothers and oocyte donors. This is particularly relevant for families opting for assisted reproductive methods such as IVF. While most health insurance plans stop at maternity coverage for the insured, Elevate goes a step further by addressing the financial implications of third-party reproductive assistance. It’s a thoughtful inclusion that makes the plan attractive to a small but growing number of families relying on modern fertility options, ensuring their unique needs are financially protected.
• Unlimited Sum Insured
  One of the standout benefits of ICICI Lombard Elevate is its option to offer unlimited coverage through the Infinite Care add-on. This allows policyholders to go beyond conventional coverage limits, making it particularly useful for those concerned about high-value treatments or long-term illnesses. In addition to this, ICICI Elevate lets you purchase the policy for 4 or even 5 years in one go. This not only provides peace of mind but also helps you lock in your premiums at today’s rates, shielding you from annual premium hikes due to inflation. 
• Consumables Coverage (via add-on)
  Consumables such as gloves, syringes, PPE kits, etc., can form a sizable portion of hospital bills. However, they are usually excluded from most health insurance claims. ICICI Elevate addresses this gap with an optional consumables add-on. By opting for this, you ensure that even the smallest medical expenses are accounted for, thereby reducing out-of-pocket costs during hospitalization. It’s a practical addition, especially for those seeking truly cashless treatment experiences without last-minute surprises. However, do note that some top health insurance policies, such as HDFC ERGO Optima Secure, have this as an in-built feature.
• Unlimited Bonus Accumulation
  ICICI Lombard Elevate also offers an industry-first feature: unlimited bonus accumulation. While most insurers cap the cumulative bonus you can earn for claim-free years, Elevate has no such restriction. As long as you don’t make a claim, your sum insured continues to grow year after year without an upper limit. This can be incredibly helpful in offsetting the impact of medical inflation and ensuring that your coverage remains adequate even as treatment costs rise.
• Maternity & Surrogacy Coverage
  The policy includes maternity benefits capped at 10% of the base sum insured, up to ₹1 lakh, and covers up to three deliveries. What makes this offering noteworthy is that it also includes both pre- and postnatal expenses—an area where many other policies fall short. Apart from maternity, the plan also covers surrogacy, which is a valuable inclusion for those who need it. These benefits make the plan attractive for young couples planning a family.

Drawbacks:

• Limited inbuilt Cumulative Bonus
  One of the noticeable limitations in the ICICI Lombard Elevate plan is the cumulative bonus structure. The policy offers a 20% increase in the sum insured regardless of claims, but only up to a maximum of 100% of the base sum insured. However, ICICI also allows you to have a 100% bonus up to 500% using the Power Booster add-on. Compared to other plans that allow in-built bonuses to accumulate up to 500% or more, this cap can feel restrictive, especially for policyholders who stay healthy and avoid claims for several consecutive years. For families or individuals seeking long-term value and steadily growing protection, this could be a limiting factor.
• Claim Settlement Ratio Needs Improvement
  While ICICI Lombard is a large and well-established insurer, its Claim Settlement Ratio (CSR) lags slightly behind some of its private sector peers. The CSR reflects the percentage of claims the insurer successfully settles, and a lower ratio could suggest potential delays or disputes during the claim process. For policyholders, this means they might face additional scrutiny or processing time when submitting claims. Although the insurer’s size and reputation are reassuring, it's worth keeping an eye on this metric, especially if hassle-free claim service is a top priority.
• Room Rent Restriction in the base plan
  Another drawback is the default room rent restriction in the Elevate base plan. The policy caps coverage to a single private room unless you purchase a separate add-on to remove the restriction. This means if you opt for a room type beyond this limit, like a deluxe or suite room, you may end up paying a significant part of the hospital bill out of your pocket, due to the proportionate deduction clause. If you prefer premium hospital accommodations, this restriction can affect the overall value of the plan unless proactively addressed with the appropriate rider.
• No Free Health Check-Ups Without Add-On
  Unlike several other health insurance plans that offer complimentary annual health check-ups as part of the base policy, ICICI Lombard Elevate includes this feature only through an optional add-on. Without this, policyholders won’t have access to free preventive screenings or diagnostic tests. This limits the proactive health monitoring benefits that many modern consumers expect from a health insurance plan. If routine health check-ups are an important part of your wellness strategy, you’ll need to account for the added cost of this rider when evaluating the overall value of the policy.

What’s Unique About ICICI Elevate?

ICICI Lombard Elevate stands out for offering policyholders the option to opt for unlimited coverage—something very few insurers in the Indian market provide. While most plans cap their sum insured at ₹1 crore or lower, Elevate’s Infinite Care add-on allows you to go beyond this limit and opt for an unlimited cover amount. This is particularly useful for those looking for extensive protection against rising medical costs, especially in cases of recurring or high-cost treatments like cancer or organ transplants. However, this benefit does come at an additional cost, so it's important to weigh your medical needs and budget before opting in.

Another notable feature is the inclusion of surrogate and oocyte donor coverage—benefits rarely found in standard health insurance policies. Under ICICI Elevate, these are covered up to ₹5 lakhs, making it a thoughtful inclusion for individuals or couples seeking assisted reproduction options. With IVF and related procedures becoming more common, this benefit ensures that policyholders don't have to purchase separate niche policies to cover such costs.

Discounts offered in ICICI Elevate

Here are the discounts that ICICI Lombard offers for the ICICI Elevate policy:

• Family Discount
  A discount is offered if two or more family members are covered under the same policy. This promotes the use of a floater plan or multi-individual policy setup.
• Long-Term Policy Discount
  If you opt for a policy term longer than one year, a discount is provided on the total premium payable upfront. Here’s how much you get:
  • 2 years: 10% discount on 2nd year premium
  • 3 years: 15% discount on 3rd year premium
  • 4 years: 15% discount on 4th year premium
  • 5 years: 15% discount on 5th year premium
• Wellness-Based Discount
  Policyholders can earn wellness points by participating in health assessments and wellness activities. These points can be redeemed for discounts on renewals.
• Online Purchase Discount
  A discount is applicable when the policy is purchased directly through ICICI Lombard’s website or digital platforms.
• Credit Score-based discount
  You can get up to a 15% discount if your credit score is good.

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Conclusion

ICICI Lombard Elevate is best suited for individuals who are looking for a plan that offers flexibility and niche benefits not commonly found in traditional health insurance policies. If you’re planning to opt for assisted reproduction and need coverage for surrogate or oocyte donor expenses, this policy is among the few that explicitly includes such benefits. It’s also a good fit for those who prefer a modular plan structure—one that allows you to tailor your coverage through multiple optional add-ons and riders based on your unique health and financial needs. 

Additionally, suppose maternity coverage is a key requirement. In that case, Elevate offers it with a relatively short waiting period of 1 to 2 years, making it a practical choice for young couples or those planning a family in the near future.