Overview

ICICI Lombard Health Shield 360 is a comprehensive health insurance policy offering coverage up to ₹3 crore, available as a retail plan or as a group policy through ICICI Bank. It features zero room rent capping, no copayment, and a restoration benefit that refills your sum insured after a claim. However, many attractive benefits, such as maternity and consumables coverage, are available as add-ons outside the base plan.

Key Features

  • No room rent capping and no disease-wise sub-limits across both variants.
  • Restoration and Bonus: Cover is restored after a claim, and your sum insured grows by 10-20% annually.
  • Add-ons cover maternity, newborn care, and consumables (Claim Protector).

Group Plan Risk: ICICI Bank is the master policyholder, so tie-ups can change or end, and later porting out may result in higher premiums.

Health insurance isn't something you choose impulsively. It's a decision you plan around your health, family, and finances.

So, when a single name covers two different products, it can cause a lot of confusion.  If you buy Health Shield 360 through ICICI Bank, you get one version, but if you buy it from ICICI Lombard, the insurer, you get another version. 

This guide breaks down both variants so you know exactly what you're committing to. We'll walk you through the features, the insurer's claims record, premiums, and the honest drawbacks most buyers miss before signing up.

Planning to buy Health Shield 360 and want to pick the right variant first? Book a free call or chat with us on WhatsApp. 

What Is ICICI Lombard Health Shield 360?

Health Shield 360 comes in two forms, and mixing them up is the most common mistake buyers make.

The group plan, ICICI Lombard Health Shield 360, is sold through ICICI Bank to account holders. It's a group health insurance policy, meaning ICICI Bank is the master policyholder, not you. The bank can change terms or end the tie-up at any time. Premiums are lower, but stability isn't guaranteed.

The retail plan, Health Shield 360 Retail, is an individual policy you purchase from ICICI Lombard. You are the master policyholder, so you control renewals, and the terms cannot be changed mid-term.

Here's how the two compare on basic details:

ParametersHealth Shield 360 GroupHealth Shield 360 Retail
Sum Insured (SI) ₹5 lakh to ₹50 lakh₹3 lakh to ₹3 crore
VariantsClassic / Classic Plus / Elite / Premier / RoyaleClassic / Classic Plus / Elite / Premier / Royale
Entry AgeAdults: 21 to 75 years, children: 91 days to 20 yearsAdults: 6 years to no limit, children: 91 days to 20 years
Exit AgeAdult: no limit, child: 21 years Adult: no limit, child: 21 years 
Waiting PeriodsInitial: 30 days (except accidents, which are covered from day 1), specific illness: 2 years, Pre-Existing Disease (PED): 1 year, 90 days for diabetes, hypertension, cardiac conditions, if not a PEDInitial: 30 days (except accidents, which are covered from day 1), specific illness: 2 years, Pre-Existing Disease (PED): 1-2 years, depending on variant, 90 days for diabetes, hypertension, cardiac conditions, if not a PED
Room Rent LimitsNot applicable Not applicable 
Disease-Wise Sub-limitsNoneNone
CopaymentNot applicableNot applicable
Pre-and Post-Hospitalization Expenses 60 and 90 days, respectively (all variants)60 and 90 days, respectively (Classic), 60 and 180 days, respectively (Classic Plus, Elite, Premier, Royale)
Daycare, Domiciliary, and AYUSH TreatmentsCovered up to SICovered up to SI

Key Features of ICICI Lombard Health Shield 360

Health Shield 360 (Group)

  1. Unlimited Restoration Benefit: Once you use part of your cover, 100% of it is restored, so you can use it again if you're hospitalized more than once in the same year. This is only applicable to different illnesses and works on partial exhaustion of SI. 
  2. Cumulative Bonus: Your sum insured increases by 10% for each claim-free year, up to a maximum of 100%. The bonus reduces at the same rate if you make a claim.
Add-OnWhat It Does
NCB SuperBoosts your bonus by an additional 50%, up to a maximum of 100%, with a 50% clawback if you claimed in the previous year.
  1. Annual Health Checkup: A full-body checkup every year is covered by the base plan, unlike the retail version.
  2. Optional Add-Ons: Maternity and Outpatient Department (OPD) consultations aren't part of the base plan. Both need to be bought separately, with coverage capped at a specified amount based on your sum insured.

Health Shield 360 (Retail)

  1. Restoration Benefit: Your cover is fully restored once for the same illness and an unlimited number of times for a different one in the same policy year. A 45-day cooling period applies to the same illness for the same insured person. This is applicable even on partial exhaustion.
  2. Cumulative Bonus: Your sum insured increases by 20% each claim-free year, up to a maximum of 100%. This is more generous than the group plan's bonus, which reduces after a claim.
Add-OnWhat It Does
NCB SuperAdds an extra 50% bonus, up to a maximum of 100%, with a 50% clawback if claimed the previous year.
Sum Insured ProtectorIncreases your cover in line with inflation each year.
  1. Claim Protector: This add-on covers 68 non-medical items, things like gloves, syringes, and administrative charges, that most base plans exclude and that can otherwise increase your out-of-pocket costs.
  2. Maternity Add-On: Covers childbirth expenses, with a waiting period of 2 to 3 years depending on the sum insured and cover option you choose. 
  3. BeFit (OPD Cover): An optional add-on for outpatient and e-consultations, capped at a limit you choose.
  4. International Coverage: Covers planned treatment abroad for up to 45 days per trip and 90 days a year, till age 65, with a mandatory 10% co-payment. It is available as an optional cover. 

For complete details on Health Shield 360 ICICI Lombard benefits, please refer to the brochures and policy wordings through the Download Center. 

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ICICI Lombard: Performance Metrics

MetricICICI LombardIndustry AverageKey Insight
Claim Settlement Ratio86.81%92.02%Below average, so a claim has a slightly lower chance of getting settled compared to top insurers. 
Incurred Claims Ratio (ICR) 79.47%81.88%Sits within the healthy 55%-85% range, showing the insurer pays out claims without overextending itself. 
Complaints (per 10,000 Claims)15.0529.35Well below average, meaning fewer policyholders report issues during their claims journey. 
Gross Written Premium (GWP) / Annual Business - Total Health (in Crore) ₹7,955₹4,798Roughly double the industry average, pointing to strong scale and a large customer base. 
Network Hospitals11,000+10,000+ (Recommended)Comfortably clears the benchmark, so cashless treatment should be easy to access nearby. 

Notes: 

For a complete picture of the insurer, check out our ICICI Lombard Health Insurance review.

Premium Sample by Age and Sum Insured

Let’s have a look at the premiums for some common profiles across both plans. 

Health Shield 360 Retail

ProfilesPremierEliteClassic Plus
(Individual Plan): Age 25₹7,163 ₹7,574 ₹13,887 
(Family Floater, 2A): Ages (31, 32)₹18,546 ₹12,521 ₹22,465 
(Family Floater, 2A 1C): Ages (35, 34, 5)₹21,307 ₹15,886 ₹26,264 
(Senior Citizens, 2A): Ages (61, 60)₹60,785 ₹71,443 ₹72,001 

Health Shield 360 Group

ProfilesPremierEliteClassic Plus
(Individual Plan): Age 25₹8,452 ₹8,937 ₹16,387  
(Family Floater, 2A): Ages (31, 32)₹21,884 ₹14,775 ₹26,509  
(Family Floater, 2A 1C): Ages (35, 34, 5)₹25,142 ₹18,745 ₹30,992 
(Senior Citizens, 2A): Ages (61, 60)₹71,726  ₹84,303 ₹84,961 

Note: A stands for adult and C stands for child. These premiums are indicative, based on a ₹10 lakh SI for healthy individuals living in Delhi (110010). Your actual premium may differ depending on age, medical history, underwriting, and location.

For more pricing details, you can refer to the ICICI Lombard Health Shield 360 premium chart.

Limitations of ICICI Lombard Health Shield 360

Limitations of ICICI Lombard Health Shield 360 (Group)

  • Group Plan Instability: Since ICICI Bank is the master policyholder, not you, it can revise the terms or end the tie-up at any time. If that happens, you could be left scrambling for a new policy, and porting to the retail variant later may not carry over the same premium or waiting period benefits.
  • Bonus Reduces After a Claim: Your cumulative bonus grows 10% a year, but it reduces at the same rate the moment you make a claim. This makes it less rewarding than retail's flat 20% growth.
  • Maternity and OPD Stay Outside the Base Plan: Both must be purchased as separate add-ons, with coverage capped at a specified amount based on your sum insured.

Limitations of ICICI Lombard Health Shield 360 Retail

  • Consumables Cost Extra: Everyday hospital items like gloves and syringes, as well as administrative charges, aren't covered by the base plan. You need the Claim Protector add-on to close this gap, and without it, these costs come out of your pocket even on an otherwise full claim.
  • Restoration Comes With a Cooling Period: While your sum insured resets after a claim, retail imposes a 45-day cooling period before you can use restoration for the same illness for the same member again. That's a gap worth planning around if you expect back-to-back treatment for the same condition.
  • Longer Waiting Periods: Specific illnesses carry a 2-year wait here, compared to 1 year under the group plan, and the PED wait can run up to 2 years, depending on the variant you pick.

Who Should Buy and Who Should Avoid ICICI Lombard Health Shield 360

Consider It If You:

    • Want a no-restriction plan with no room-rent capping and no disease-wise sub-limits. 
    • Are an ICICI Bank customer who's comfortable with the group plan's lower premium and bank-linked risk, and don't mind the trade-off in stability.
    • Want retail's stronger cumulative bonus, 20% a year even after a claim, over the group plan's 10% bonus that shrinks when you claim.
    • Need to cover consumables and non-medical hospital expenses through an add-on.
    • Prioritize a low complaint volume. At 15.05 per 10,000 claims, ICICI Lombard performs well below the industry average here.

Avoid It If You:

    • Rank the claim settlement ratio as your top priority. At 86.81%, ICICI Lombard trails the industry average of 91.22%, so it's worth comparing against insurers with a stronger track record.
    • Want maternity, OPD, or annual health checkups included in the base plan at no extra cost. Health Shield 360 includes most of these as add-ons, and retail doesn't include a free checkup at all.
    • Need guaranteed policy stability without a bank as an intermediary. If you're buying through ICICI Bank, remember the bank can alter or end the group tie-up at any time.
    • Expect to file repeat claims for the same illness in quick succession. Retail's 45-day cooling period on restoration could leave you without cover right when you need it.

Why Choose Ditto for Health Insurance? 

At Ditto, we’ve assisted over 8,00,000 customers with choosing the right insurance policy. Why customers like Pallavi below love us:

ICICI Lombard Health Shield 360 Review
    • No-Spam & No Salesmen
    • Rated 4.9/5 on Google Reviews by 25,000+ happy customers
    • Backed by Zerodha
    • Dedicated Claim Support Team
    • 100% Free Consultation

Confused about the right insurance? Speak to Ditto’s certified advisors for free, unbiased guidance. Book your call now or chat with our advisors on WhatsApp.

Conclusion

ICICI Lombard Health Shield 360 delivers solid core benefits, including no room rent capping, no disease-wise sub-limits, and a genuine restoration feature. But the plan only makes sense once you're clear on which variant you're buying. The group plan is tied to ICICI Bank's terms. The retail plan costs more but hands you full control, a stronger bonus, and add-ons like Claim Protector that the group plan simply doesn't offer.

Before you commit, weigh the insurer's claim settlement ratio against what matters most to you. The insurer’s CSR number has improved fairly in 2025-26 to 91.96%, but the average still remains low. At 86.81%, ICICI Lombard trails the industry average, though its low complaint volume and wide hospital network are genuine strengths worth factoring in too.

If a smoother claims experience outweighs everything else for you, it's worth comparing this plan with other comprehensive options. You can refer to our guide on the best health insurance plans in India before finalizing your decision.

Frequently Asked Questions

What is Health Shield 360 ICICI Lombard?

Health Shield 360 ICICI Lombard is a comprehensive health insurance policy available in two forms, a group plan sold through ICICI Bank and a retail plan bought directly from the insurer. At Ditto, we recommend checking which version you are being offered, as the two differ in their sum insured ranges, waiting periods, and bonus structures. The retail plan covers ₹3 lakh to ₹3 crore, while the group plan covers ₹5 lakh to ₹50 lakh. Both offer zero room-rent caps, no disease-specific sublimits, and no copayments, making them solid options for full hospitalization coverage.

What is the difference between Health Shield 360 and Health Shield 360 Retail?

The core difference comes down to who controls the policy. Health Shield 360, the group version, is sold through ICICI Bank, which holds the master policy, so the bank can change the terms or end the tie-up at any time. Health Shield 360 Retail is an individual policy you control directly, with better terms, such as a 20% annual cumulative bonus even after a claim, compared to the group plan's 10% bonus that shrinks after a claim. At Ditto, we always suggest reading the fine print before assuming both versions offer identical protection.

What are the main Health Shield 360 ICICI Lombard benefits?

The standout Health Shield 360 ICICI Lombard benefits include zero room rent capping, no disease-wise sub-limits, and a genuine restoration feature that refills your sum insured after a claim. The retail variant adds a strong 20% cumulative bonus each year, even after a claim, up to a maximum of 100%. At Ditto, we also highlight the low complaint volume, just 15.05 per 10,000 claims against an industry average of 27.06, along with a network of over 11,000 hospitals, which makes cashless treatment fairly easy to access nearby.

What are the disadvantages of Health Shield 360 ICICI Lombard?

The biggest Health Shield 360 ICICI Lombard disadvantages start with the claim settlement ratio of 86.81%, which trails the industry average of 91.22%. Maternity, OPD consultations, and consumables coverage are not part of the base plan and need separate add-ons, which raises your overall premium. At Ditto, we also flag that the group plan carries an instability risk, since ICICI Bank holds the master policy and can end the tie-up at any time, while the retail plan applies a 45-day cooling period before restoration kicks in again for the same illness.

What does the ICICI Lombard Health Shield 360 premium chart show?

The ICICI Lombard Health Shield 360 premium chart compares indicative annual premiums across profiles like a 25-year-old individual, a couple aged 31 and 32, a family with a young child, and senior citizens aged 60 and 61. For instance, a senior-citizen couple pays around ₹60,785 for the Premier retail variant, with a ₹10 lakh sum insured. At Ditto, we recommend treating this chart as a starting point only, since underwriting decisions and your actual location can significantly affect the final premium.

What is the claim protector add-on in Health Shield 360 Retail?

Claim Protector is an add-on that covers 68 non-medical items, things like gloves, syringes, and administrative charges that most base health plans exclude. Without this add-on, these costs come out of your pocket even on an otherwise fully approved claim. At Ditto, we consider this add-on especially useful since consumables can quietly inflate your out-of-pocket hospital bill even when the core treatment cost is covered. This add-on is available for both variants of Health Shield 360 and is recommended to be added right at the time of purchase.

Does Health Shield 360 have room rent limits?

No, Health Shield 360 has no room rent capping across both the group and retail variants, meaning you can choose any available room, from shared to deluxe, without the insurer restricting your choice. There are also no disease-wise sub-limits on either version. At Ditto, we point out one nuance, though, some lower-tier base variants may still limit you to a single private room, so you need to check whether your specific variant or add-on fully unlocks the zero-room-rent benefit before assuming unrestricted access.

What is the restoration benefit in Health Shield 360?

The restoration benefit refills your sum insured after you use part of it through a claim, so you aren't left without cover mid-year. Under the group plan, this is unlimited, meaning 100% of your cover is restored each time you're hospitalized again in the same year. The retail plan restores your cover fully once for the same illness, with a 45-day cooling period, and unlimited times for a different illness. At Ditto, we consider this one of the most valuable features across both variants.

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