ICICI Lombard
Health Shield 360 Retail
ICICI Lombard's Health Shield 360 Retail is a solid plan on paper. It has short waiting periods (1-2 years) for pre-existing conditions. It extends coverage of up to ₹3 crores. It offers OPD benefits, and add-ons like sum insured protector (an inflation shield for your sum insured) and claim protector (coverage for medical items used during hospitalisation). However, ICICI Lombard's low claim settlement ratio is something that will worry customers and we aren’t sure we would actively recommend this plan.
What's good here?
You’ll never have to split the bill
The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.
The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.
You can pick any room you like
Shared room, single room, deluxe room or any room that’s available. The insurer won’t nitpick on your choice of room since the policy has no restrictions on room rent.
Reasonable waiting period for pre-existing diseases
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after you wait for 1-2 years.
Good Restoration Benefit
Even after you claim part of the cover on one occasion, you will have 100% of the cover restored once for the same illness and unlimited times for different illness, so that you can use this benefit in the event you have to endure multiple hospitalizations.
Special Bonus for being healthy and not claiming insurance
Your sum insured increases by 20% each year, so long as you make no claims during this period. But before you get too ahead of yourself, do note that they’ll stop offering you the bonus when your sum insured increases by 100%. But hey, it's still a bonus.
No Cover for Alternative Medicine
Think of getting Ayurvedic, Homeopathic or other alternative treatment to cure an illness. Tough Luck!!! Your insurer won’t cover this expense.
You always have full cover irrespective of the disease
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
Pre & Post hospitalization expenses covered
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.
Day Care treatments covered
If you’re hospitalized for less than 24 hours in lieu of a minor procedure, then the insurer will cover these costs too. Think dialysis, chemotherapy or minor surgeries.
Full coverage even if you are forced to hospitalize at home
The insurer will bear the costs even if you are hospitalized at home due to a condition or the hospital running out of beds. In insurance lingo, they call this a policy with domiciliary cover.
Add-ons
Sum Insured Protector
With this add-on, the insurer will increase your cover in line with inflation every year.
Annual Health Check-ups
With this add-on, you get free health checkups every year subject to certain limits and tests prescribed in the policy document. However you can only claim this on a cashless basis at one of the network hospitals.
BeFit cover
With this add on, you can get coverage for outpatient and e-consultations i.e. doctor visits.
Hospital Cash
With this add-on, the insurer will hand out cash every day you stay at the hospital subject to certain limits. The cash is expected to replace your income during the course of your hospitalization
Nursing at home
With this add-on, the insurance company will payout a certain amount each day for medical services of a nurse at residence for a maximum of 15 days post hospitalization.
Convalescence Benefit
With this add-on, the insurance company will payout a fixed amount in case the hospitalization exceeds more than 10 continuous days. This benefit is available once per insured member per policy year.
Claim Protector
With this add-on, you also get extended coverage for generally excluded items like syringes, gloves, PPE kits etc.
NCB Super
With this add-on, you get an additional bonus of 50% for every claim free year upto 100% of the base sum insured
Maternity
With this add-on, you get added coverage for maternity expenses i.e. childbirth . However, the coverage is limited based on the plan taken with Maternity Waiting Period ranging between 2-3 years.
International Coverage
With this add-on you get coverage for planned treatment for 45 days per trip and total of 90 days per year till the age of 65 years. You will have to bear a mandatory co-payment of 10% for this.
Compassionate Visit
With this add-on, the insurance company will payout a maximum of ₹20,000/year to cover the cost of economy class air ticket in case an Immediate Family member is visiting the insured person for hospitalization extending more than 5 days.
Dependent Accommodation
With this add-on, the insurance company will pay a specified amount for the accommodation of the dependent in the hospital if the hospitalization is of at least 3 days.
Frequently Asked Questions
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