banner-logo

All You Need To Know

Features

Life is truly priceless and protecting one’s health is essential. With Health Insurance, the Insured can medically cover himself/herself and his/her family members for Sum Insured as per one’s needs at an affordable premium. ICICI Lombard Smart Health Insurance Policy covers major hospitalization and daily expenses arising due to unfortunate events or medical conditions. Day care treatment, organ transplantation, and domiciliary hospitalization expenses too are included depending on the variant cover.

  • Sum Insured Flexibility: As per one’s requirement, one can choose Sum Insured from Rs. 2 lakh, Rs. 3 lakh and Rs. 5 lakh. These are variants of the Smart Health Insurance Policy.
  • No sublimit on room rent: The policy offers one the flexibility to choose any room for getting treated in a hospital as there is no capping on room rent in any variant of the plan.
  • Critical Illness benefit: One would also have the option of taking cover against listed 20 Critical Illnesses
  • Tax benefits: Under Section 80 D of the Income Tax Act 1961, one can avail of Tax benefit. Tax benefits are subject to change as per change in Tax laws, please consult tax advisor for details.
  • Discount on renewal: Discount that is equivalent to 5% of renewal premium each year is provided.
  • Medical Check up: One also receives reimbursement of medical check-up expenses at the end of four continuous years.
  • Additional Benefits: Up to certain limit of sum insured, one can receive extra benefits of hospital cash allowance, home nursing allowance, and reimbursement charges for in-patient physiotherapy and ambulance.
Inclusions Exclusions
• Hospitalization If one is admitted to a cashless or non-cashless hospital for a hospitalization period of 24 hours, the medical treatment expenses are either directly paid by ICICI Lombard to the hospital or it is reimbursed to the insured.
• Pre- and post-hospitalization expenses All expenses such as diagnosis, doctor’s fees, medicines, etc. for treatment before hospitalization as well as after hospitalization are covered.
• Domiciliary hospitalization: Care and treatment of domiciliary hospitalization involving medical treatment for a period exceeding 3 days for disease, illness, injury which is taken whilst confined at home in India, is covered. . The condition is the patient cannot be admitted to a hospital for lack of accommodation or other medical reasons.
• Day Care Treatment: Day care treatment is covered, in this, 24-hour hospitalization is not needed for dialysis, eye surgery, chemotherapy, eye surgery,lithotripsy, D&C, tonsillectomy taken in a hospital/nursing home.
Critical Illness Covered:
If opted for, the cover is provided for:
• Cancer
• First Heart Attack
• Coronary Artery Disease
• Coronary Artery bypass surgery
• Heart Valve Surgery
• Surgery to Aorta
• Stroke
• Kidney Failure
• Aplastic Anemia
• End Stage Lung Disease
• End Stage Liver Failure
• Coma
• Major Burns
• Major Organ/Bone Marrow
• Transplantation
• Multiple Sclerosis
• Fulminant Hepatitis
• Motor Neurone Disease
• Primary Pulmonary Hypertension
• Terminal Illness
• Bacterial Meningitis		 • Expenses within 30 days of policy inception: Hospital expenses for treatment of illness that are undertaken within 30 days of buying the policy
Exclusions for first 2 years:
Cataract, laser surgery
Myomectomy, Hysterectomy unless because of malignancy
Dilation and curettage
Hernia, Hydrocele, fistula in anus, sinusitis, hemorrhoids/piles
Joint replacement, unless due to accident
All types of skin and all internal tumors / cysts / nodules / polyps of any kind, including breast lumps, unless malignant
Dialysis required for chronic renal failure
Gastric and duodenal erosions & ulcers
Permanent exclusions
Routine medical, eye and ear examinations, cost of spectacles
Dental treatment
Circumcision, sex change or treatment
Birth control procedures, hormone replacement therapy, caesarean section, fertility or conception operation
Acquired Immune Deficiency Syndrome (AIDS) and related diseases/illness related to HIV
Pre-existing diseases
Certain pre-existing diseases, illness or injury are covered only after completion of 4 years of waiting period from starting date of policy.
Card Reward and Redemption

Eligibility Criteria

  • All individuals between 91 days to 65 years of age can opt for the plan
Card Reward and Redemption

Important Notes

  • Please note the following important on commission for the general issuance of the plan

Commission on General Insurance

Card Reward and Redemption

Frequently Asked Questions

Tax benefit can be claimed by the one who actually pays the premium i.e. the proposer.

 

Yes, hospitalization due to sickness or accident forms a part of the coverage under the Hospitalization Section and/or In-hospital benefit Section of the policy

 

Medical tests like x-ray, lab tests are payable only if the Insured is hospitalized as an inpatient and has incurred those expenses either during actual hospitalization or corresponding pre-post hospitalization period & the subject hospitalization claim is admissible as per the terms & condition of the policy.

 

By Pre-existing Condition, means any condition, ailment or injury or related condition(s) for which the signs or symptoms were diagnosed, and / or received medical advice/ treatment, within 48 months prior to the first policy issued by the insurer.

For calculation of premium, one needs to take completed age/age on last birthday.

 

Dental treatment is covered only in case of an accidental dental injury.

 

The Medical Expenses incurred by an Insured Person for medical treatment taken at his home which would otherwise have required Hospitalisation because, on the advice of the attending Medical Practitioner, the Insured Person could not be transferred to a Hospital or a Hospital bed was unavailable. The condition for which the medical treatment is required should continue for at least 3 days.

 

Renewal for whole life means that once the customer chooses to buy Health Insurance from Bharti AXA, on payment of premium within due timeline, his/her policy will be renewed and he/she will be covered under the insurance unless the policy is cancelled by insurer due to misrepresentation or fraud, irrespective of health status and claims made. This policy does not have any exit age.

 

A family floater covers the family members under a single sum insured which floats among all the covered insured members. A family coverage with individual Sum Insured plan includes independent sum insured for each family member.