ICICI Lombard Arogya Sanjeevani Policy

India is a nation of the young aspiring to achieve their goals. When you are young, you plan and save for your dream car, dream home or vacation to a dream destination, but buying health insurance never crosses your mind until you have a family. This happens because it is difficult to choose a health insurance cover from the vast number of choices available in the market, and finding the right amount of coverage is even more difficult.

IRDAI introduced Arogya Sanjeevani Policy to solve this problem and made it compulsory for all insurance companies to provide this standardised product.

ICICI Lombard Arogya Sanjeevani Policy takes care of your medical expenses when you are hospitalised. It is suitable for the basic coverage needs of the customers. ICICI Lombard General Insurance Company offers 24x7 customer support for claim settlement with speedy claim approvals through a network of 6500+ health network providers.

To understand the ICICI Lombard Arogya Sanjeevani Policy, let us look at the coverage and benefits of the policy.

• Sum Insured: The policy offers coverage for your hospitalisation expenses up to Rs. 10 lakhs. The sum insured offered starts from Rs. 50,000 to Rs. 10 lakhs.

• In-patient Hospitalisation: The policy covers basic hospitalisation expenses such as room rent, boarding and nursing expense up to 2% of the sum insured per day with a maximum limit of Rs. 5000 per day. It also covers ICU charges upto 5% of the sum insured daily with a maximum limit of rs. 10,000 per day. It also covers doctor’s fees, surgeon’s fees, OT charges, blood, oxygen etc., for more than 24 hours of hospitalisation. The policy also covers pre and post-hospitalisation expenses for 30 and 60 days, respectively.

• Day-care Procedures: Hospitalisation expenses for less than 24 hours are also covered under daycare procedures.

• Ambulance Cover: Ambulance expenses are covered up to Rs. 2000 per hospital visit.

• In-patient AYUSH Treatment: Any alternative treatment taken under AYUSH is covered, provided the treatment is done in a government-recognized hospital or institute.

• Cataract: Medical expenses for cataract treatment are covered up to 25% of the sum assured or Rs. 40,000, whichever is lower.

• Dental Treatment and Plastic Surgery: Any dental treatment or plastic surgery required due to an injury for reconstruction purposes is covered by the policy up to the limit specified in the policy.

• Floater Benefit: The policy offers extended coverage for your family through the family floater option, in which the sum insured can be shared by all the family members, including spouse, dependent children, parents and parents-in-law.

• Cumulative Bonus: The company offers a cumulative bonus of 5% for every claim-free year.

• Lifelong Renewable: The policy is lifelong renewable without any exit age.

• Tax Benefits: ICICI Lombard General Insurance Company offers tax benefits up to Rs. 25000 under section 80D of the Income Tax Act on premiums paid towards this policy. Senior citizens get a benefit of up to Rs. 50,000.

• Free Look Up: A free look-up period of 15 days is available from the date of receipt of the policy for cancellation of the policy.

• Pre-policy Medical Check-Up: No pre-policy medical check-up is required till the age of 45 years.

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The policy does not cover any claim arising due to

• Hospitalisation for evaluation purposes

• Diagnostic tests not related to the treatment

• Domiciliary hospitalisation

• OPD costs

• Injury because of participation in adventure sports

• Maternity expenses and fertility treatments

• Procedure for obesity control

• Gender change treatment

• Rehabilitation treatment

• Any treatment taken outside India

• Refractive error correction treatment

• Breach of law.

ICICI Lombard health insurance claim settlement procedure is simple, hassle-free, and fast.

Cashless claim:

A cashless facility is available only at the network hospitals and can be availed 24/7 for any of the health insurance policies by ICICI Lombard. Notify the claim to the insurance company for planned hospitalization at least 48 hrs in advance with details of the hospital and treatment. For emergency hospitalization, inform the company within 24 hrs of the hospitalization.

• Get a pre-authorization form.

• Send the duly filled and signed pre-authorization form with relevant documents to the insurance company.

• ICICI Lombard team will review your claim and accept or reject it.

• Once approved, an authorization letter is issued, and the hospital sends the final bill with discharge details to the company.

• The company settles the claim.

For a cashless claim, the insured only needs to show his photo id and health card, the rest of the other documents are provided by the hospital.

Reimbursement claim:

For reimbursement, the insured sends an intimation to the company with all the necessary documents within 30 days of discharge. The company will verify all the documents and the reimbursement request and settle the claim per the policy.

A complete set of documents needs to be submitted to the insurer for reimbursement. These documents include a duly filled and signed claim form, the Patient’s photo id, his prescription stating hospitalisation, original medical bills and payment receipts, discharge summary, diagnostic test reports, bank details and KYC details of the proposer and any other document required by the insurance company.

ICICI Lombard Arogya Sanjeevani Policy clears all the doubt and confusion that keeps you from securing yourself and your family. It is a perfect health insurance plan to cover your basic medical requirements for your lifetime.