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What is ICICI Lombard MaxProtect

What is ICICI Lombard's MaxProtect health insurance policy with 1 croreU sum insured?

Are you tired of worrying about financial constraints regarding your & your family's health? Imagine a future where you can access the best healthcare services without worries.

With MaxProtect health insurance, you can prioritise health and well-being without financial burden. Our 1 crore medical insurance policy with extensive coverage ensures you and your family are protected from emergency & planned medical expenses with no concerns about reaching an undersized coverage limit.

MaxProtect health policy, in addition to covering the usual benefits such as in-patient hospitalisation & daycare treatments, also includes worldwide coverage for medical treatments outside the country. With this policy, you can stay confident of never running out of coverage with an unlimited sum insured reset benefits, unlimited teleconsultation services for informed healthcare decisions and guaranteed private hospital rooms for you or your family in case of hospitalisation.

Why is 1 crore health insurance plan needed?

1

Medical inflation

Healthcare costs are soaring, and a 1 crore insurance cover provides a substantial financial cushion to confidently manage the high expenses associated with quality medical treatment.

2

Lifestyle diseases

With lifestyle diseases becoming increasingly common, such as diabetes, heart disease, and obesity, a 1 crore insurance cover ensures comprehensive coverage for these conditions. You can face these health challenges head-on, knowing that your insurance will provide the necessary financial support for treatments and long-term management post a waiting period.

3

Sufficient coverage

By choosing a high SI, you can rest assured that, regardless of the cost of treatment, your health insurance coverage will be more than sufficient. Whether it's major surgery, critical illness, or emergency medical care, the range ensures that you have adequate funds to meet the cost of treatment.

why_is_1cr_ins_plan_needed

Benefits of buying a health policy with 1 crore sum insured

1

Extensive coverage

Get complete protection against various medical expenses with a health plan offering a 1 crore sum insured.

2

No coverage limit worries

Don't worry about running out of coverage. With a 1 crore sum insured, you have sufficient coverage for your & your family's medical needs.

3

Access to top healthcare

Access the best healthcare services without financial concerns. Choose renowned hospitals and doctors without compromising on quality.

 
4

Coverage for various medical expenses

MaxProtect includes coverage for in-patient and daycare treatments, pre and post-hospitalisation expenses, domiciliary care, modern treatments, donor expenses, and even road and air ambulance services.

5

WorldwideT Coverage Option

Some plans offer coverage for medical treatments outside the country, which is beneficial if you travel frequently or require specialised treatments abroad.

6

Reset BenefitsS

MaxProtect also provides unlimited sum insured reset benefitss for any illness or injury, ensuring ongoing support for your medical needs.

 
7

Guaranteed Cumulative Bonus (GCB):

If you rarely claim your insurance, you can receive 20% increased coverage each claim-free year until your total SI increases by 100%. So that you can ensure you have sufficiently adequate coverage whenever needed.

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Features of ICICI Lombard's MaxProtect 1 crore health insurance

High Coverage

With a 1 crore coverage, you have substantial insurance coverage to address a wide range of medical expenses.

In-patient and Daycare Coverage

The plan covers hospitalisation and daycare treatment expenses, ensuring you receive necessary medical care without financial worries.

Pre and Post-Hospitalisation Coverage

It includes coverage for medical expenses incurred before and after hospitalisation, such as diagnostic tests, medications, and follow-up consultations.

Modern Treatment Coverage

The plan typically offers coverage for advanced and modern medical treatments such as stem cell therapy, oral chemotherapy, robotic surgeries & more, ensuring you have access to the latest healthcare technologies and procedures.

Worldwide Coverage Option

The premium plan covers medical treatment & day care hospitalisations worldwideT after the waiting period.

Guaranteed Cumulative Bonus

Offers a Guaranteed Cumulative Bonus feature, where the sum insured increases for every claim-free year, rewarding you for maintaining good health.

Value-added services

Fastrack your knowledge & access to reliable doctors and hospitals. Get assistance in booking an emergency ambulance & avail of discounts on your medical expenses.

Multi-year policy discounts

Get 10% & 15% discounts on your premium for 2 & 3-year policies, respectively.

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Coverage of ICICI Lombard's MaxProtect 1 crore health insurance policy

  • Inclusions
  • Exclusions
  • Room rent

    All rooms except suite available up to Sum Insured
  • In-patient treatment

    Coverage for hospitalisation up to the sum insured
  • Daycare procedures & treatments

    Coverage for daycare treatments requiring less than 24 hours of hospitalisation (including dialysis, radiotherapy and chemotherapy).
  • Coverage for Modern Treatments

    Coverage for a list modern treatments up to SI or max up to 1 crore
  • Pre-hospitalisation

    Coverage for expenses incurred 60 days before hospitalisation
  • Post-hospitalisation

    Coverage for expenses incurred 180 days after hospitalisation
  • Domiciliary hospitalisation

    Coverage for treatment taken at home up to the sum insured
  • Donor expenses

    Coverage for expenses related to organ transplantation up to the sum insured
  • In-patient AYUSH

    Coverage for AYUSH treatments taken during hospitalisation up to the sum insured
  • Domestic road ambulance:

    Coverage of up to Rs.10,000 for road ambulance services
  • Air ambulance cover  

    Coverage for air ambulance services up to the sum insured (applicable only for specific plans)
  • Homecare treatment  

    Coverage for homecare services up to 1 Lakh
  • Bariatric surgery

    Coverage up to the sum insured for weight loss surgery, if recommended
  • Worldwide coverT  

    Up to 3 crores coverage for medical treatments outside the country
  • Reset benefitS

    Unlimited times sum insured reset for the same illness if exhausted in a policy year
  • Guaranteed Cumulative Bonus (GCB)

    Coverage increases by 20% yearly and can increase to 100% on renewal for every claim-free year
  • Claim protector  

    Coverage of expenses towards non-payables, as per IRDAI's excluded list of items up to sum insured
  • Health check-up  

    Covers up to Rs. 10,000 cost of health check-ups once a year
  • Teleconsultation

    Unlimited teleconsultation services, available 24x7
  • Medical Second Opinion For Critical Illness  

    Covers cost of a second opinion worldwideT if diagnosed with a critical illness
  • Value-added services

    Access to Health Assistance (HAT), emergency ambulance booking & discounts on medical expenses
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  • Pre-existing diseases and their direct complications are excluded until 48 months of continuous coverage. Opt for the pre-existing disease waiver add-on to reduce it to 24 months.

  • Some diseases/procedures such as cataract treatment, hernia, varicose veins & more are excluded for 24 months, except for accident claims.

For a complete list of exclusions, please refer to the policy wordings.

  • All types of external congenital anomalies/illnesses/defects such as gender change treatments, expenses related to birth control, infertility, cosmetic or plastic surgery expenses unless medically necessary & more are not covered by this policy.

ICICI Lombard MaxProtect health insurance coverage is a good fit if

ICICI Lombard's MaxProtect health insurance coverage is a good fit if

1

You're a health-conscious individual who values well-being and financial security during medical emergencies.

2

You or your family members have pre-existing conditions, as MaxProtect offers extensive coverage after the waiting period.

3

You're seeking coverage & access to a list of modern treatments and advanced medical procedures.

4

You are a frequent international traveller or have family members who live abroad and can benefit from global coverage.

5

You're looking for a no-tension extensive health benefits policy that includes daycare treatments, pre and post-hospitalisation expenses, in-patient AYUSH treatments, and more for you and your family.

ICICI Lombard's MaxProtect optional add-ons

MaxProtect offers optional add-ons to enhance your health insurance coverage. Here are the add-ons available:

Pre-existing disease waiting period reduction

This add-on reduces the waiting period for pre-existing diseases and their complications from 48 to 24 months. If you increase your sum insured, the exclusion will apply to the additional coverage.

MaxProtect optional add-ons

Steps to claim one crore health insurance

Claim guarantee for reimbursement & cashless claims

For cashless hospitalisation, get a response from us within 2 hours of raising the pre-authorisation request at our network hospitals.

Planned Cashless Everywhere hospitalisation

Follow the below steps to avail of Cashless Everywhere hospitalisation in hospital outside out network:

1

Inform us before hospitalisation: For a planned hospitalisation, inform us at least 24 hrs. prior. Use the IL Take Care app to tell us you plan to get hospitalised.

2

Choose Cashless Everywhere: Inside the IL Take Care app, select the Services we offer tab and choose the Health Assistance option for Cashless Everywhere.

3

Easy discharge: Once your treatment is done, you can leave the hospital without paying any money at the time of discharge, based on the terms and conditions of your insurance policy.

Planned hospitalisation in network hospital

1

Check if the hospital is on the empanelled list of network hospitals.

2

Submit the pre-authorisation form and relevant documents to your insurance provider a few days before the hospitalisation.

3

Get treated

4

Our claims officer reviews the documents submitted by the hospital while you are being treated. These include discharge summaries, hospital bills, pharmacy bills, investigation reports, payment receipts and doctor's consultation papers. They may request a few more relevant documents if required.

5

Easy discharge

6

The claim, if approved, is settled by us directly. All you need to do is sign the relevant papers before getting discharged.

Note:
1

If your claim is not approved - you may still complete your treatment. You must clear the hospital dues and may apply for a reimbursement claim. Also, remember to obtain your original documents from the hospital.

2

If a query is raised - by the insurance company, you may need to follow up with them and submit relevant/additional documents required for processing the claim.

Emergency cashless hospitalisation

Follow the below steps to avail of Cashless Everywhere hospitalisation in hospital outside out network:

1

Emergency: In an emergency, head directly to the nearest network hospital for treatment.

2

Cashless hospitalisation: Once you're at the hospital - Show your e-health card and government recognised ID proof at the hospital TPA (Third Party Assistance) desk and leave the rest to us.

3

The TPA will submit a pre-approval request for cashless hospitalisation to us for further processing, which has a turnaround time of 60 minutes from receipt of complete documents, on best effort basis. Please note you may have to pay for non-medical expenses not covered in your policy.

4

Company review: We will review the hospital bills after providing provisional cashless authorisation while you get treatment. The claim, if approved, is settled by us directly. All you need to do is sign the relevant papers before getting discharged.

Process for reimbursement claims

For reimbursement claims under MaxProtect health insurance of 1 crore, follow these steps:

1

Notify us: Inform us about the claim through our toll-free 24x7 helpline 1800 2666 or website, providing policy details and the nature of the claim.

2

Submit documents: Prepare and submit the necessary documents, including claim forms, medical records, bills, discharge summaries, and prescriptions.

3

File the claim: Submit the form and documents to the online claim portal.

4

Claim verification: We will review the documents and may seek additional information if needed.

5

Claim settlement: Once verified, we will process the claim as per policy terms.

6

Reimbursement or cashless settlement: Depending on your reimbursement preference, you'll receive a refund, or we will directly settle the bill with the hospital through the cashless facility.

Steps to apply for a 1 crore health insurance plan online

  • Visit the MaxProtect health insurance web page section of the ICICI Lombard website.
  • Enter basic information such as contact details, proposer's information, pre-existing illness details & other details.
  • Customise your policy by choosing the desired sum insured, policy terms, and other details.
  • Make an online payment using our secure payment gateway.
  • You can also contact us on our toll-free number for assistance while purchasing the policy.
Steps to apply for a 1 crore health insurance plan online

Who is eligible to buy the 1 cr. health insurance policy?

Eligibility to purchase the Classic & Premium plan of the MaxProtect policy is based on the following criteria:

Age

Children can be covered from as young as 91 days (for floaters) or 6 years (for individuals) up to a maximum age of 20. Adults are eligible for coverage starting at 21 and up to 65 years old.

Sum Insured (SI) options

The Classic plan offers a range of SI options, including 1 crore and unlimited coverage. You can select the SI option that suits your coverage needs.

Policy tenure options

You can choose the duration of your policy from options of 1, 2, or 3 years and get additional discounts for multi-year policies.

Make Instant Claims With ICICI Lombard

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ICICI Lombard's MaxProtect Classic vs Premium plan comparison

Key benefits Classic Premium
Room rent Coverage for hospital room charges during your stay All rooms except suite All rooms except suite
In-patient hospitalisation Expenses covered for hospital stays exceeding 24 hours
Daycare treatments Coverage for medical procedures that don't require overnight hospitalisation
Coverage for modern treatments Coverage for a list of advanced and cutting-edge medical treatments
Pre hospitalisation Medical expenses covered before hospital admission 60 days 60 days
Post hospitalisation Coverage for medical expenses after hospital discharge 180 days 180 days
Domiciliary hospitalisation Coverage for medical treatment received at home
Donor expenses Coverage for medical expenses related to organ transplantation procedures
In-patient AYUSH Coverage for AYUSH treatments during hospitalisation
Domestic road ambulance Coverage for ambulance services within the country
Reset benefit Renewal of coverage amount after exhausting the sum insured in a given policy year
Guaranteed Cumulative Bonus (GCB) Bonus for claim-free policy years 20% every claim free year up to 100% 20% every claim free year up to 100%
Teleconsultation Access to medical consultations via phone or video calls
Value-added service Coverage for health assistance & emergency services
Bariatric surgery Coverage for weight loss surgeries
Claim protector Covers expenses towards non-payables, excluded from coverage as per IRDAI
Homecare treatment Cashless coverage for medical treatments provided at home
1 lakh cashless only
Air ambulance cover Coverage for air ambulance services during medical emergencies
Worldwide cover Insurance coverage extends globally for medical treatments
Health check-up Coverage for preventive health check-ups
Medical Second Opinion For Critical Illness Coverage for seeking a second medical opinion globally for a critical illness

Frequently asked questions on Maxprotect policy for family

  • General
  • Cover
  • Premiums
  • Claims
  • Policy

What is ICICI Lombard MaxProtect?

ICICI Lombard MaxProtect is a high-sum insured (1 crore and more) comprehensive health insurance policy that covers various medical expenses and offers additional features and benefits when you fall sick or get injured.

Why should I get the MaxProtect 1 crore health insurance policy?

Health insurance provides financial protection and ensures you can afford medical treatment when needed. By opting for a sum insured amount of 1 crore, you can rest assured that all your emergency medical expenses will be covered. This will enable you to focus on your recovery and get access to the best medical facilities for your or your family's treatment.

What are the benefits of ICICI Lombard MaxProtect?

MaxProtect offers extensive hospitalisation, treatments, additional services, and more coverage, with a high insurance sum of up to 1 crore that enables you to access the best doctors and hospitals for your treatment in your time of need.

What is the age limit for buying this policy?

The minimum age limit for taking this policy is 21 years, and the maximum is 65 years.

Can I buy the MaxProtect policy for my whole family?

Yes, you can purchase MaxProtect for your entire family, including your spouse, children, and parents, providing them with substantial insurance coverage.

How do I contact ICICI Lombard for more information?

Read through the ICICI Lombard MaxProtect web page for more information on covers & exclusions or contact customer service for more details about the MaxProtect policy and its benefits.

What does the MaxProtect policy cover?

The MaxProtect policy covers hospitalisation expenses, treatments, pre and post-hospitalisation expenses, modern treatments, emergency medical services, international coverage (Premium plan only), and more. Please refer to the policy document for detailed coverage information.

Can I avail treatment outside India under this policy?

Yes, the MaxProtect premium plan covers medical expenses outside India post a waiting period.

Will the health insurance cover hospitalisation expenses for COVID-19?

Yes. Covid-19 related hospitalisation is covered in the policy.

Does the MaxProtect policy cover surgeries?

Yes, MaxProtect covers the costs of surgeries, including the expenses incurred pre & post your surgery, up to the generous coverage limit of 1 crore.

Will my doctor's fees be covered under this policy?

Yes, the policy covers doctor's fees incurred during hospitalisation and medical expenses before and after hospitalisation for follow-up checkups.

Are all the major corporate hospitals on the network?

With ICICI Lombard's Anywhere Cashless service, you can get hospitalised in any hospital near you by informing us 24 hours beforehand. You can claim reimbursement if you need emergency hospitalisation and cannot tell us ahead.

What treatments are covered under additional treatment coverage?

Additional coverage includes day care treatments, modern treatments, AYUSH treatments, and bariatric surgery.

Does the policy cover emergency medical services like ambulance expenses?

Yes, MaxProtect covers expenses for road ambulance and air ambulance services in critical emergencies.

What are the different modes of payment on icicilombard.com?

You can choose between any of these payment options to pay your premium online:
  • Credit Card – Make secure premium payment with your VISA, Master, AMEX, RuPay or Diners Club card.
  • Net banking - Transfer the premium amount online through ICICI Bank or any of the other 50+ banks.
  • Debit Card – Just enter your bank's debit card details to pay your insurance premium directly.
  • UPI and e-wallets - Pay through UPI apps such as Google Pay, BHIM UPI & PhonePe, or an online wallet.
  • EMI - Use the credit/debit card EMI facility to pay your premium in instalments

How are the premiums calculated for the MaxProtect policy?

The premiums for the MaxProtect policy are based on factors such as age, sum insured, policy duration, and any optional add-ons chosen.

Will my premium be the same when I renew my policy?

Your premium depends on your age and the benefit amount/coverage period you have opted for in your policy. If you move to a higher age band at the time of renewal, the premium will change as per the new age band. If you upgrade your product to a higher sum insured at the time of renewal, add covers or make changes to the coverage period, your premium will change.

What is the grace period for making a premium payment?

A grace period for payment of premium of 30 days applies for premium payments. If the premium is not paid within the grace period, the policy shall lapse and cover shall cease.

Are there any discounts available on the premiums?

Yes, ICICI Lombard offers a 10% discount on premiums if purchased online via the website, 10% & 15% discounts for 2 & 3-year multi-year policy purchases & 10% employee discounts.

What factors can affect the premium amount?

Age, sum insured, add-ons, and pre-existing conditions can affect the premium amount.

How can I raise my health insurance claim post-hospitalisation?

In case of planned hospitalisation, you can pick any hospital of your choice to avail of the Anywhere Cashless hospitalisation feature, by informing us 24 hours before. You can claim reimbursement for hospitalisation expenses in an emergency where you must pick a non-network hospital for immediate care. To raise a reimbursement claim, contact us by using any of the following ways:

Who do I call at the time of emergency hospitalisation?

You can contact us on our toll-free number, 1800 2666 or SMS "HEALTHCLAIM" to 575758 for a callback. Use the health card at any network hospital to avail of our cashless service. Contact us within 24 hours of hospitalisation for cashless emergency hospitalisation.

What do I do if my claim is rejected?

A claim can be rejected for several reasons, such as an incomplete waiting period, incorrect information provided, delay in making a claim & others. If your claim is denied, you can ask the reason for such rejection. If you're not convinced, you can contest the decision.

How can I file a claim for MaxProtect health insurance policy?

We have a 3-step claims process:
  • Step 1: Claim Reporting - You can report your claims online, at our branches, central office, via SMS, email or through our call centre as per your convenience. Once you have uploaded all the documents required to process your claim, we take 14 days to respond with an acceptance, rejection or queries.
  • Step 2: Claim Processing - Our dedicated ClaimCare team will assess your claim and inform you if any more documents need to be submitted. Post receiving all the necessary documents, we will process your claim request.
  • Step 3: Claim Settlement - Once your claim is intimated and we receive all the relevant documents, we will settle your claim.

How long does it take to settle a claim?

ICICI Lombard aims to settle reimbursement claims within 14 days of submitting all claim documents. For cashless claims, we respond within 2 hours for pre-authorisation approval for cashless payments.

Am I allowed to change the policy term for MaxProtect insurance cover once I have bought the policy?

No, the policy term cannot be changed once the policy is issued.

Can I return the policy if I am not satisfied with it?

We provide a 15-day free look period. You may cancel this policy in the free look period by giving us written notice, and then we shall refund the premium.

Do I need a pre-medical check-up before buying the MaxProtect policy?

You will be informed if you need to get a medical check-up done based on the health details submitted by you. Generally, if you're above 45 years of age, then a pre-medical check-up will be required.

What happens if I don't renew my policy on time?

We provide a grace period of 30 days from the expiry of the policy. Beyond this period, you lose your renewal benefits, including continuity benefits required to cover pre-existing diseases. You will have to apply for a fresh policy post the grace period.

How do I purchase the MaxProtect policy?

You can purchase the MaxProtect policy online through the ICICI Lombard website or by contacting our customer service helpline.

Can I add my family members to the MaxProtect policy?

Yes, you can add your spouse, children, and parents to the MaxProtect policy under the family floater option.

Can I customise the coverage as per my needs?

The MaxProtect policy offers a range of coverage options that can be customised to suit your requirements, including selecting the desired insurance coverage of 50 lakhs, 1 crore & more.

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Product Product Code UIN no.
MaxProtect 4223 ICIHLIP24084V012324

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