ICICI Lombard General Insurance Company Limited
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ICICI Lombard General Insurance Company Limited
Family Floater Health Insurance
A comprehensive Health Insurance policy that ensures... Poorey parivaar ki poori suraksha. Secure your family against financial emergencies during sudden illness, surgery and accidents as well as against terrorist activities.

Family Floater Health Insurance plan lets you share the entire sum insured among the family members covered under the policy, without any individual upper limits.

Example
The Prakash Family is covered under a traditional health insurance plan with individual policies, of which Mr. Prakash is separately covered for Rs. 2 Lakhs, his wife for Rs. 1 Lakh, their son and daughter for Rs. 50,000 each. They have paid premium for all these four policies separately. In an unforeseen situation, wherein surgery and post hospitalisation bill of their son amounts to Rs. 1.30 Lakhs, the existing policy will cover only Rs. 50,000, while Mr. Prakash will have to bear the balance Rs. 80,000 from his pocket. However, with Family Floater Health Insurance plan, each member of the Prakash family can utilize the entire sum insured of Rs. 4 Lakhs. Thus in the above situation, Family Floater would have covered the entire amount of Rs. 1.30 Lakhs of medical expenses of his son.

Policy Details


Key Benefits
  • Comprehensive coverage for your family with floater benefit
  • Cashless claims facility at over 3,500+ network hospitals across India
  • Continue to enjoy quality service even during claim settlements with - ICICI Lombard Health Care - our own in-house health claim processing and wellness team
  • No sub-limits on room rent, doctor fees, and hospital charges or for
    any disease (except Cataract where Rs. 20,000 per eye is applicable).
  • No co-payments for any disease or any hospitalisation expenses
  • Now get a Free health check-up coupon for any one insured family member, valid for the policy period

  • Key Benefits
    • Comprehensive coverage for your family with floater benefit
    • Cashless claims facility at over 3,500+ network hospitals across India
    • Continue to enjoy quality service even during claim settlements with - ICICI Lombard Health Care - our own in-house health claim processing and wellness team
    • No sub-limits on room rent, doctor fees, and hospital charges or for any disease*
    • No co-payments for any disease or any hospitalisation expenses
    • Now get a Free health check-up coupon for any one insured family member, valid for the policy period
    • No health check-up up to the age of 55 years (age as on last birthday)
    • Avail tax benefits under Section 80D of the Indian Income Tax Act 1961**
    • Buy Online and pay in EMIs without any extra charges***
    • Options for one or two year covers (auto renewal) available
    • Get additional Sum Insured for every claim free year
    • Keep your family secured even against expenses for hospitalisation due to terrorist
      activities

    * Except Cataract where Rs. 20,000 per eye is applicable
    ** Tax benefits are subject to tax laws. Click here to calculate your tax saving
    *** EMI facility available only for ICICI Bank, Citibank and HDFC Bank (up to 6 months) credit card
    customers at the sole discretion of the Banks.


    Note: EMI option subject to minimum annual premium of Rs. 10,000. Click here to know more.



    What is covered
    • Medical expenses incurred as an inpatient during hospitalisation for more than
      24 hours, including room charges, doctor/ surgeon's fee, medicines bills, etc
    • Medical expenses incurred 30 days prior and 60 days post hospitalisation
    • Day Care expenses incurred on named advanced technological surgeries and
      procedures requiring less than 24 hours of hospitalisation. (Including Dialysis,
      Radiotherapy and Chemotherapy)

    What is covered
    • Medical expenses incurred as an inpatient during hospitalisation for more than
      24 hours, including room charges, doctor/ surgeon's fee, medicines bills, etc
    • Medical expenses incurred 30 days prior and 60 days post hospitalisation
    • Day Care expenses incurred on named advanced technological surgeries and
      procedures requiring less than 24 hours of hospitalisation. (Including Dialysis,
      Radiotherapy and Chemotherapy)
    • Pre-existing diseases can be covered after four continuous years of coverage with
      the Company*
    • This policy also covers you for hospitalisation in case of Swine Flu / H1N1
      influenza**
    * Conditions Apply
    ** If it's not a pre-existing illness

    Terms of Renewability

    Your Family Floater Health Plan can be renewed instantly. Click here to know more.

    View Premium Table

    For complete details, refer to the Policy Wordings.



    What is not covered

    Exclusions valid for the first 30 Days
    • Any illness contracted within 30 days of the inception date of the Policy, except those
      that are incurred as a result of an accident. This clause is not applicable on the
      subsequent renewals

    What is not covered
    Exclusions valid for the first 30 Days
    • Any illness contracted within 30 days of the inception date of the Policy, except those
      that are incurred as a result of an accident. This clause is not applicable on the
      subsequent renewals

    Exclusions valid for the first 2 Years
    • Treatment of the following diseases/illness/ailments:
    • Cataract
    • Benign Prostatic Hypertrophy
    • Myomectomy, Hysterectomy unless because of malignancy
    • Hernia, Hydrocele
    • Fistula in Anus, Piles
    • Arthritis, Gout, Rheumatism
    • Joint replacement, unless due to accident
    • Sinusitis and related disorders
    • Stone in the urinary and biliary systems
    • Dilatation & Curettage
    • Skin and all internal tumors / cysts / nodules / polyps of any kind, including breast
      lumps, unless malignant / adenoids and hemorrhoids
    • Dialysis required for chronic renal failure
    • Surgery on tonsils, adenoids and sinuses
    • Gastric and duodenal ulcers

    If the Policy is renewed with us for two consecutive years, the above diseases / illness /
    ailments will be covered from the third year. If these are pre-existing diseases at the
    time of inception of the policy, the same will be covered after the fourth year onwards, subject to continuous renewal of the policy with us.

    Permanent exclusions
    • Any illness/ disease/ injury/ pre-existing disease before the inception of the policy.
      However, this exclusion ceases to apply if the policy is renewed with the Company
      for 4 consecutive years
    • Non-allopathic treatment, pregnancy and childbirth related complications, cosmetic,
      aesthetic and obesity related treatment
    • Expenses arising from HIV or AIDS and related diseases, use or misuse of liquor,
      intoxicating substances or drugs as well as intentional self injury
    • War, riots, strike, nuclear weapon, induced treatment

    For details, kindly refer to Policy Wordings.


    Eligibility
    • The customer can buy the policy for any family member(s) children and / or
      parents
    • The senior most person to be insured should be between 5 to 60 years of age.
      (Persons aged 60 and above can consider our Health Advantage Plus plan, in
      which the age of the senior most person is up to 65 years)
    • The Proposer needs to be aged above 18 years

    Eligibility
    • The customer can buy the policy for any family member(s) children and / or
      parents
    • The senior most person to be insured should be between 5 to 60 years of age
    • The Proposer needs to be aged above 18 years
    • To cover children aged between 91 days to 5 years, the policy must also cover at
      least 1 adult under the same policy
    • Children under less than 91 days old cannot be covered
    • Individual(s) proposed for Insurance whose age is 56 years & above have to
      undergo medical tests at ICICI Lombard designated diagnostic centers
    • The policy cover is renewable till the age of 70 years
    • Income Tax benefits u/s 80D can only be availed for policies bought for Self, Spouse,
      Children or Parents
    • Floater benefit under the policy is available up to the age of 60 years. All floater
      policies thereafter will be renewed under individual plan up to the age of 70 years
    For details, kindly refer to Policy Wordings.



    Claims


    Health Insurance and You

    What is health insurance?
    A health insurance policy will provide a cover to you and your family against sudden medical contingency or bodily injury.

    Why health insurance?
    Every human being is exposed to various health hazards.
    Medical emergency can strike anyone without pre-warning.
    Inadequate facilities in government hospitals
    Private hospitals are too expensive
    Medicines have become quiet expensive
    Diagnostic charges are beyond common man’s reach
    Specialists come at a price
    Tax benefit under section 80 D of the Income Tax Act
    Health risk is a personal risk, which could arise from various factors viz.
    a) Physical condition
    b) Psychological condition
    c) Accident related
    d) Occupational related
    e) Environment related
    f) Life style related
    g) Travel related


    Continue reading

    What is the kind of medical emergency that can strike?
    A medical emergency can be:-
    Medical illness
    Injury / Accident
    Major illness
    Critical illness
    Chronic illness
    Untreatable
    Terminal

    What impact will a medical emergency have on you and your family?
    A medical emergency can
    Burn a hole in your pocket
    Immediate need for medical aid
    Loss of quality life
    Loss of career options / Income
    Disruption in home life
    Mental trauma and incapacitation

    What does a standard insurance policy cover?
    A standard health insurance covers :
    Room and boarding expenses provided by the hospital
    Nursing expenses
    Diagnostic and medicine expenses
    Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist fees
    Anesthesia, blood, oxygen, operation theatre expenses, cost of surgical appliances, medicines and drugs and similar expenses
    Pre-hospitalisation and post hospitalization expenses subject to conditions and limits .

    What are the benefits of buying health insurance at a young age?
    Health insurance premium tends to increase with age -- more the age, higher the premium.
    You can be covered for medical conditions that may be diagnosed over the years provided there is no break in the policy.
    In addition, each `no claim’ year would fetch you a discount on your premium or an increase in your sum insured amount at no extra cost. The treatment in case of ‘no-claim’ bonus varies from company to company.
    Lastly, income tax benefit under Section 80 D of the Income Tax Act.

    How is premium determined?
    Premium depends on several factors viz.
    Your age
    Amount of coverage required
    Number of family members covered
    Other additional benefits
    Your health condition
    Your income \ earning

    How does a health policy differ vis-à-vis a life insurance policy?
    The health insurance plan is more comprehensive in its coverage. All expenses involved in hospitalization fall under its purview. Life insurers usually cover critical illness and hospital cash extensions (only room rent charges) on life policies, which do not include doctor’s fees, expenses incurred on buying medicine and surgery costs etc.

    Why is it important to disclose health details when I buy a policy?
    Mention of details is critical since insurance companies assess the policyholder’s risk profile on the basis of his/her health. An insurance contract works on the principal of “utmost good faith”, which implies that information furnished by a policyholder is true and correct. Moreover, non-disclosure can also lead to rejection of a claim.











    Family Floater Health Insurance Product Code: Misc 34E

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    Testimonials
    Mr. Ajit Deshpande,
    Pune - Maharashtra
    “I am quite amazed to buy a policy from ICICI Lombard. There was no paperwork, no health check-up, no cheque payments, no reminder calls etc."
    Read more
    Smart Tip


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