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1. What do you mean by a pre-existing disease?

Any condition, ailment or injury or related condition(s), for which you have had signs or symptoms, and/or were diagnosed, and/or received medical advice/treatment, within 36 months prior to the first policy with the insurance company is called a pre-existing disease.


To know more, watch this video - https://customersupport-icicilombard.kpoint.com/web/videos/gcc-12adf938-d413-4a18-b934-1131de334a2b/play?id=series_10&utm_source=WhatsApp&utm_campaign=LombardInternal&utm_RefNo=

2. What is waiting period?

The duration after which you can make a claim is called a waiting period. Our waiting periods for ICICI Lombard Health AdvantEdge and Health Booster policy are as below

  • No waiting period for accidental hospitalisation.
  • 30 days for all claims other than accidental hospitalisation.
  • 2 years for pre-existing diseases. These diseases should be declared at the time of proposal and accepted by us for policy with sum insured of ₹3 lakh and above.
  • 2 years for standard list of diseases and procedures.

Watch this video to know more -


https://customersupport-icicilombard.kpoint.com/web/videos/gcc-5045c50d-36fe-4073-9512-c32727c56f9d/play?id=series_16?utm_source=WhatsApp&utm_campaign=LombardInternal&utm_RefNo=

3. What does annual sum insured mean?

Annual (basic) sum insured is the maximum amount that an insurance company will pay you in the event of a claim in a policy year.

4. If I increase my sum insured at the time of renewal, does a waiting period apply?

5. My employer provides me with a health insurance. Do I still need one?

Numerous employers offer group or individual health plans. However, these are not customised as per your needs and may have certain restrictions and limitations. Also, the coverage is dependent on the continuation of the job. Once you quit, you cannot avail the health plan benefits. Therefore, it is important to insure yourself with a comprehensive cover that lets you customise as per your needs. For example, for a family of 4 members, a sum insured of ₹2 lakh-₹3 lakh provided by your employer may be inadequate.

6. From what age can I include my children in the plan?

You can include your children aged between 91 days to 20 years in your policy based on the plan you choose. Newborns can be included after 90 days of birth. However, your daughter or son cannot be shown as a ‘dependent’ if they file a joint tax return.



Want to learn about Tax Benefits in Health Policy? Watch Video -

https://customersupport-icicilombard.kpoint.com/web/videos/gcc-8f6d3014-a570-4a27-8eae-5a4a4c4d3b6e/play?id=series_13?utm_source=WhatsApp&utm_campaign=LombardInternal&utm_RefNo=

7. Which health insurance policy is ideal?

If you have a family, you should choose a family floater health insurance over an individual health plan. It not only protects your entire family but also helps you save a lot on premiums.

8. What is the advantage of health insurance?

Health insurance plans provide cover for unexpected medical expenses. It covers an array of costs incurred on daycare procedures, hospitalisation, ambulance and domiciliary hospitalisation. Apart from this, you can also get tax benefits on your health insurance policy.


Check this video to learn more - https://customersupport-icicilombard.kpoint.com/web/videos/gcc-8f6d3014-a570-4a27-8eae-5a4a4c4d3b6e/play?id=series_13?utm_source=WhatsApp&utm_campaign=LombardInternal&utm_RefNo=

9. Can a person have more than one health insurance policy?

Yes, you can buy multiple health insurance policies to cover your medical costs. If one insurer rejects your claim, there is still a chance that others may accept as per its terms and conditions.

10. What is the right age to buy a health insurance policy?

It is recommended that you obtain a health insurance policy as soon as possible. Purchasing insurance at a young age allows you to earn a loyalty bonus for every claim-free year under your policy. And as you get older, you will be able to accumulate higher and better coverage.

11. What to do if I am admitted to a non-network hospital?

If you get admitted to a non-network hospital, you have to pay for the medical treatment costs out of your pocket. Post-discharge, you can submit all the relevant documents such as medical bills and ambulance receipts for the reimbursement claim. Post verification, the claim amount will be transferred to your bank account.


Watch this video to understand more about Reimbursement Claims - https://customersupport-icicilombard.kpoint.com/web/videos/gcc-eb00dff8-0d6d-45e9-ac77-f662be4fb02c/play?id=reimbursement?utm_source=WhatsApp&utm_campaign=LombardInternal&utm_RefNo=

12. How does the GST waiver affect my health insurance premium

With the 18% GST waiver, you now pay only the premium amount for your health insurance and zero taxes without compromising on coverage or benefits.


Learn more about Tax Benefits with Health Insurance here - https://customersupport-icicilombard.kpoint.com/web/videos/gcc-8f6d3014-a570-4a27-8eae-5a4a4c4d3b6e/play?id=series_13?utm_source=WhatsApp&utm_campaign=LombardInternal&utm_RefNo=

13. Will my existing health insurance policy also receive the GST benefit?

Yes, all existing health policies that are due for renewal on or after 22nd September will be tax-free.


Watch this video to understand more about Tax Benefits with Health Insurance - https://customersupport-icicilombard.kpoint.com/web/videos/gcc-8f6d3014-a570-4a27-8eae-5a4a4c4d3b6e/play?id=series_13?utm_source=WhatsApp&utm_campaign=LombardInternal&utm_RefNo=

14. How much GST do I have to pay on health insurance?

Effective 22nd September 2025, GST on health insurance has been reduced to 0%. This means your health insurance is tax-free.


Watch this video to learn more - https://customersupport-icicilombard.kpoint.com/web/videos/gcc-8f6d3014-a570-4a27-8eae-5a4a4c4d3b6e/play?id=series_13?utm_source=WhatsApp&utm_campaign=LombardInternal&utm_RefNo=

15. My claim is already registered. How do I upload additional documents?

You can upload additional documents using the IL TakeCare app

Steps:

  1. Open the IL TakeCare app

  2. Go to Claims → select your registered claim.

  3. Tap Upload Documents and add the required files.

  4. Review the selected documents and tap Submit.

File upload guidelines:

  • Supported formats: PDF, JPG, PNG
  • Max size per file: 10 MB
  • You can upload multiple documents (each document must be within the 10 MB limit)

Important: After you submit documents, they cannot be deleted. You can remove/replace files before final submission.


Watch this video to learn how to register a claim - https://www.icicilombard.com/health-insurance-claim-process?utm_source=WhatsApp&utm_campaign=LombardInternal&utm_RefNo=

16. What documents do I need to submit for a health claim?

Documents may vary depending on the treatment and claim type. Below are the commonly required documents.

Mandatory documents (commonly required):

  • Claim form duly filled and signed
  • Discharge summary
  • Final hospital bill(main bill) and itemised bills (if any)
  • Hospital payment receipts supporting the bills
  • Investigation reports (e.g., ECG/CT/MRI/USG/HPE, as applicable)
  • Doctor’s prescriptions and pharmacy/medicine bills
  • Cancelled cheque (for bank details)

Additional documents (if applicable):

  • ICICI Lombard authorisation letter / consent letter (if asked)
  • Implant invoice + implant sticker (if implants used)
  • Indoor case papers
  • Consultation papers
  • Age proof / ID proof (PAN/Driving Licence/Passport)

Tip: Upload clear, readable copies to avoid delays.

17. How do I fill the health claim form (Part A, B, C and KYC)?

The claim form has different sections to be filled by different people.

  1. Part A (Customer/Insured): Fill patient, policy and hospitalisation details.
  2. Part B (Hospital/Treating Doctor): Must be filled by the hospital/doctor.
  3. Part C (Proposer/Account Holder): Fill proposer’s bank details for payout.
  4. KYC Section: Fill proposer’s KYC details and attach required documents (if requested).

Still unsure? Watch - https://www.icicilombard.com/health-insurance-claim-process?utm_source=WhatsApp&utm_campaign=LombardInternal&utm_RefNo=

18. How can I upload my health claim documents online?

You can upload documents by simply clicking here - https://www.icicilombard.com

19. How are claims processed for the BeFit rider/policy?

Claims under the BeFit rider/policy are processed on a cashless basis through the IL TakeCare app, subject to:

  • Policy terms and conditions
  • Waiting periods and exclusions
  • Availability of Annual Sum Insured
  • Network/anywhere cashless guidelines (as applicable)

To know more about Health Claims, click here - https://www.icicilombard.com/health-insurance-claim-process?utm_source=WhatsApp&utm_campaign=LombardInternal&utm_RefNo=

21. Can I use Anywhere Cashless in an emergency admission?

Yes, Anywhere Cashless is available for emergency admissions, subject to policy terms and applicable process.


Learn more about the cashless claim process here – https://customersupport-icicilombard.kpoint.com/web/videos/gcc-acb8624d-6f64-4377-b644-18362a35b0bb/play?id=cashlessClaim&utm_source=WhatsApp&utm_campaign=LombardInternal&utm_RefNo=

22. Who should fill Part B of the health claim form?

Part B must be filled and signed by the hospital or the treating doctor.

23. When can I submit pre- and post-hospitalisation expenses?

You can submit pre- and post-hospitalisation expenses after the main hospitalisation claim is registered or processed, as per your policy terms and admissibility.

24. By when should I submit my hospitalisation claim after discharge?

We recommend submitting your claim within 30 days of discharge to avoid delays in processing.

25. Do I need Part B (hospital section) for pre/post-hospitalisation claims?

No, Part B is not mandatory for pre- and post-hospitalisation claims.

26. How can I share my health claim documents with ICICI Lombard?

You can share documents in either of the following ways:


Option 1 (Recommended): Upload digitally


Option 2: Send hard copies (if required)


ICICI Lombard GIC Ltd., 1st Floor, Varun Towers-II,
Opp. Hyderabad Public School, Begumpet,
Hyderabad – 500016, Telangana.

27. How do I upload my claim documents?

You can upload query documents in the IL TakeCare app

  • From the Home screen, tap Register a claim and select Policy.
  • Tap Track Your Claim
  • Select UHID/Patient Name, then select the Claim Number.
  • Scroll down to view the claim status.
  • If the claim status shows Query, you will see an option to Upload Documents.
  • Upload the required documents (max file size 10 MB per file; format PDF/JPG).
  • Review the uploaded documents and submit.

Alternatively, you can chat with RIA on WhatsApp at 7738282666 to upload your query documents

28. In how much time will my claim get settled?

Cashless Claims:

  • Initial approval (Cashless Authorization): within 1 hour of receipt of request
  • Final approval: within 3 hours of the receipt of discharge authorization request from the hospital

Watch this video to know more about Cashless Claims - https://customersupport-icicilombard.kpoint.com/web/videos/gcc-acb8624d-6f64-4377-b644-18362a35b0bb/play?id=cashlessClaim&utm_source=WhatsApp&utm_campaign=LombardInternal&utm_RefNo=



Reimbursement Claims:

  • Claim settlement Turnaround Time (TAT) is 15 days from submission of claim

Watch this video to know more about Reimbursement Claims - https://customersupport-icicilombard.kpoint.com/web/videos/gcc-eb00dff8-0d6d-45e9-ac77-f662be4fb02c/play?id=reimbursement&utm_source=WhatsApp&utm_campaign=LombardInternal&utm_RefNo=


Watch this video to learn about the entire Health Claim Process – https://www.icicilombard.com/health-insurance-claim-process?utm_source=WhatsApp&utm_campaign=LombardInternal&utm_RefNo=

29. Where can I find the list of delisted, network, and PPN hospitals?


Alternatively, you can chat with RIA for quick information about our network and delisted hospitals. Send a Hi at 7738282666

30. What is the definition of a PPN hospital?

A PPN (Preferred Provider Network) hospital is a hospital that has a tie-up with your health insurer. These hospitals offer cashless treatment at fixed rates, which helps reduce unexpected charges. This can also make the claim process faster when you choose a PPN hospital. Note - This is an add-on cover for our Elevate customers only.

31. How can I book a doctor consultation in the IL TakeCare app?

  • Tap Benefits.
  • Tap Health and select Tele consultation.
  • Select the member who wishes to avail the tele consultation and tap Submit.
  • Choose Audio or Video consultation.
  • Upload relevant medical documents (if any) and mention the health issue, then tap Submit.
  • You will receive a reference number.
  • You will receive a call from our service team, who will connect you with the required GP/specialist (based on your requirement).
  • Post consultation, the prescription will be sent to your registered email ID.

32. Where can I get an option for tele-consultation?

  • On the IL TakeCare app, go to Benefits.
  • Tap Health and select Tele consultation.
  • Select the member name and tap Submit.
  • Choose Audio or Video consultation.
  • Upload relevant medical documents (if any) and mention the health issue, then tap Submit.

If you still do not see the option, please update the app to the latest version and try again.

33. When will I get the appointment confirmation and where will I receive it (on the IL TakeCare app or over email)?

Once you have confirmed your appointment timings, you would be notified on WhatsApp.

34. How can I book a health check-up through the IL TakeCare app?

You can book a Health Check-up by clicking on the Health Check-up icon under the ‘Benefits’ section on the Home page. You can also book a Health Check-up with RIA on WhatsApp at 7738282666. Just send “Health Check-up”

35. How can I download my E-card through the IL TakeCare app?

  • Go to ‘Policy’ tab → Go to ‘Health’ → Select your Policy
  • Select ‘E-card’ and then the member’s name to Download E-card

36. What is the difference between indemnity and benefit policies?

Indemnity – An indemnity policy reimburses the policyholder for the actual financial loss incurred (up to the sum insured). It is based on the principle of indemnity — no profit, only compensation.


Benefit – A benefit policy pays a fixed, pre-agreed amount on the occurrence of a covered event, regardless of the actual expenses incurred.

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