What is sum insured in health insurance?
Sum insured is the maximum amount that an insurance company will pay in the event of a claim in a policy year. Suppose you have an annual sum insured of ₹10 lakhs and your hospitalisation bill amounts to ₹12 lakhs. In this case, your insurer will pay up to ₹10 lakhs as per the policy’s terms and conditions.
What do you mean by a pre-existing disease?
A pre-existing disease refers to any health condition or illness diagnosed about 36-48 months prior to buying a health insurance policy. You need to complete the applicable waiting period before your policy starts covering the disclosed pre-existing disease.
What do you mean by waiting period?
Waiting period is the specified period of time you need to wait before you can enjoy coverage for certain illnesses, treatments or pre-existing diseases.
If I increase my sum insured at the time of renewal, does a waiting period apply?
Yes. The increased sum insured will attract a waiting period.
My employer provides me with a health insurance. Do I still need one?
Yes. While having a corporate health insurance is helpful, the coverage ends when you switch jobs. Therefore, it is important to insure yourself with a comprehensive health insurance to ensure continuous, customisable coverage.
From what age can I include my children in the plan?
You can include your children aged 90 days to 30 years in your family floater health insurance policy.
Which is the best health insurance policy for me?
It depends on your needs. For example, you can opt for a family floater health insurance if you want to cover multiple family members under a single policy. However, you can also opt for an individual health insurance policy for wider coverage.
What is the advantage of buying health insurance?
Health insurance not only protects you from rising medical costs but also provides cashless hospitalisation, day care treatments, wellness programmes, health check-ups, etc. Apart from this, you can also get tax benefits on your health insurance policy under the old tax regime.
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 their terms and conditions.
How does lifestyle (smoking/alcohol consumption) affect health insurance premium?
Smoking or drinking regularly may increase the chances of health issues in the future and health insurance companies factor it into their underwriting and pricing structure.
What is the right age to buy a health insurance policy?
Health insurance premiums are generally lower when you are young and healthy. This helps you save money. Additionally, buying early helps you complete waiting periods for specific illnesses before you might actually need them.
What is the difference between sum insured and sum assured?
Sum insured is the maximum amount you can get when you file a health insurance claim whereas sum assured is the fixed payout paid under a life insurance policy on death or maturity.
Is health insurance mandatory in India?
No, but it is strongly recommended as health insurance policy protects you against rising healthcare costs.
Can NRIs or foreigners living in India buy health insurance?
Yes, NRIs can buy medical insurance for themselves and their families (spouse, children and parents) residing in India, subject to underwriting norms.
Can minors buy health insurance independently?
No. Minors cannot buy a health insurance policy. Parents can cover their children aged 90 days to 30 years under their family floater health insurance.
Does health insurance cover OPD expenses?
Yes, OPD expenses are covered only if you have opted for the OPD+ rider or BeFit add-on with your ICICI Lombard health insurance policy.
Is health insurance valid outside India?
Most health insurance policies offer usually domestic coverage. However, you can opt for Worldwide Cover add-on to get international coverage.
Can I change the nominee during the policy term?
Yes. You can change or update your nominee by submitting an endorsement request via your insurer’s website or mobile app.
Are daycare procedures covered under health insurance?
Yes. Day care procedures/treatment are one of the basic covers offered by ICICI Lombard health insurance policies.
Does health insurance cover modern treatments like robotic surgery?
Yes. Elevate health insurance covers robotic surgeries under its Technological Advancements and Treatments cover.
Are diagnostic tests like MRI, CT scan and PET scan covered?
Yes, health insurance policies cover diagnostic tests when they are part of hospitalisation and medically necessary.
Is home treatment or domiciliary hospitalisation covered?
Yes, if treatment is taken at home due to medical necessity and subject to policy conditions.
Are alternative treatments like AYUSH covered?
Yes, ICICI Lombard health insurance covers AYUSH treatments.
Does health insurance cover maternity expenses?
You can get coverage for maternity expenses by opting the Maternity Benefit (add-on) available under our Elevate health insurance.
Are ambulance charges covered in health insurance?
Yes. ICICI Lombard health insurance covers road ambulance expenses.
Which diseases are permanently excluded from health insurance?
Depends on your health insurance policy. You can go through the exclusions listed in your policy document for detailed information.
What to do if I am admitted to a non-network hospital?
When you get treatment at a non-network hospital, you need to pay for the medical costs out of your pocket first and later raise the bills with your insurer for reimbursement. You can also check with your insurer to avail cashless treatment through the ‘Cashless Everywhere’ Initiative.