Get basic coverage at an affordable premium

Arogya Sanjeevani Policy, ICICI Lombard pays for your medical bills when you are hospitalised. It is well suited for securing your basic healthcare needs. It also lets you cover your family on floater basis. With us, you get to make the most of our 24x7 customer support for settling your cashless claims.

7 reasons to buy Arogya Sanjeevani Policy, ICICI Lombard

Secures medical costs for AYUSH treatment

Your hospital bills for alternative treatments like Ayurveda, Yoga, Unani, Siddha and Homeopathy are covered.
Avail tax benefit

As per section 80D, you can save up to ₹25,000 in taxes on securing yourself, your dependent parents and children, and up to ₹50,000 if you are a senior citizen.
Speedy approvals for your claims

With a customer care team that works round the clock, your cashless claims are bound to be settled faster.
99.8% health claim settlement ratio (FY19)

Our robust processes help settle a higher number of claims. So if you make a claim, rest assured your claims will be handled smoothly.
Enjoy extra sum insured on every claim-free year

Get 5% additional sum insured as a Cumulative Bonus up to a maximum of 50% on every claim-free year. You don’t have to pay an extra premium for the additional sum insured.
Receive cashless medical care at your nearby hospital

Our wide network of more than 6025 hospitals ensures you get quality medical care at the right time in your vicinity.
Choose a sum insured that you are comfortable with

From ₹1 Lakh to ₹5 Lakh, choose how much you want as your sum insured. Depending on what you choose, your premium will vary.

Arogya Sanjeevani Policy Wordings Glossary Read FAQs

UNDERSTAND YOUR AROGYA SANJEEVANI POLICY, ICICI LOMBARD COVERAGE

Your policy coverage and benefits:

In-patient hospitalisation:
In-patient hospitalisation expenses like room rent/boarding and nursing up to 2% of sum insured subject to a maximum of ₹5,000 per day. Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) charges up to 5% of sum insured subject to a maximum of ₹10,000 per day. The surgeon’s fee, doctor’s fee, anaesthesia, blood, oxygen, operation theatre charges incurred during your hospitalisation for more than 24 hours are also covered.
Pre and post hospitalisation:
Medical expenses incurred 30 days prior and 60 days post hospitalisation.
In-patient AYUSH treatment:
Alternative treatments like Ayurveda, Unani, Siddha and Homeopathy (AYUSH) undergone in a government hospital or any institute recognised by the government and or accredited by Quality Council of India/National Accreditation Board.
Day care procedures:
Medical bills for all the day care treatments that require hospitalisation for less than 24 hours.
Emergency Ambulance cover:
On road ambulance charges up to ₹2000.
Cataract treatment:
Expenses incurred during a cataract treatment up to 25% of the sum insured or ₹40,000, whichever is lower.
Dental treatment and Plastic surgery:
Medical costs for treating a disease arising out of an injury.

Pre-existing diseases:
Specified pre-existing diseases after 4 years waiting period (refer policy wordings for list of PEDs). The waiting period benefit applies to ported policies.
Floater benefit:
Extension of the coverage of your single policy to your family (legally wedded spouse, dependent parents and parents-in-law, dependent children) by paying one premium amount on floater basis. You can get any child above 3 months of age covered under the policy provided one adult is also covered under it.
Tax benefits:
Tax deductions up to ₹25,000 under section 80D on securing your health and that of your dependent parents and children. Senior citizens can avail tax benefit up to ₹50,000.
Lifelong renewability:
Flexibility to renew your policy every year without a capping on the age.
Cumulative bonus:
5% additional sum insured on every claim-free year up to a maximum of 50% of sum insured for the same premium amount.
Free look period:
Cancellation of policy by giving written notice within 15 days of receiving the policy.

The following modern procedures are also covered either as in patient treatment or as part of day care treatment in a hospital up to 50% of Sum Insured

Uterine Artery Embolization and HIFU (High intensity focused ultrasound)
Balloon Sinuplasty

Deep Brain stimulation
Oral chemotherapy
Immunotherapy- Monoclonal Antibody to be given as injection
Intra vitreal injections
Robotic surgeries
Stereotactic radio surgeries
Bronchical Thermoplasty
Vaporisation of the prostrate (Green laser treatment or holmium laser treatment)
IONM - (Intra Operative Neuro Monitoring)
Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered

Your policy does not cover:

Any admission primarily for diagnostic and evaluation expenses
Diagnostic expenses that don’t relate to the treatment you are undergoing
Costs incurred for nursing at home
OPD expenses
Costs incurred by non-allopathic treatment, unproven treatment, treatment of pregnancy and childbirth related complications, cosmetic, aesthetic and obesity related treatment
Expenses arising out of professional participation in hazardous or adventure sports
Costs incurred for the treatment of alcoholism or drug or substance abuse
Expenses incurred at spas and nature cure clinics
Bills for dietary supplements and substances that are not prescribed
Expenses for eyesight correction treatment arising out of refractive error less than 7.5 dioptres
Expenses related to fertility and infertility
Expenses arising out of war, civil war, nuclear attack, chemical or biological attack or breach of law
Costs incurred for treatments out of India

Following treatments, disorders and conditions for the first 2 years:

Benign ENT disorders
Tonsillectomy
Adenoidectomy
Mastoidectomy
Tympanoplasty
Hysterectomy
All internal and external benign tumours, cycts, polyps of any kind, including benign breast lumps
Benign prostate hypertrophy
Cataract and age related eye ailments
Gastric/ Duodenal Ulcer
Gout and Rheumatism
Hernia of all types
Hydrocele
Non Infective Arthritis
Piles, Fissures and Fistula in anus
Pilonidal sinus, Sinusitis and related disorders
Prolapse inter Vertebral Disc and Spinal diseases unless arising from an accident
Calculi in the urinary system, Gall bladder and Bile duct, excluding malignancy
Varicose Veins and Varicose Ulcers
Internal Congenital Anomalies

Following treatments, disorders and conditions for the first 4 years:

Treatment for joint replacement unless arising from an accident
Age-related Osteoarthritis & Osteoporosis

CHECK YOUR ELIGIBILITY FOR AROGYA SANJEEVANI POLICY, ICICI LOMBARD

You are eligible to avail this standard health insurance plan if:

You /Your legally wedded Spouse /Parents/ Parents In law are in the age group of 18 years to 65 years
Your dependent children are in the age group of 3 months to 25 years

Please note that if your children are above 18 years of age and are financially independent, they will be ineligible for coverage in the subsequent renewals

ABOUT AROGYA SANJEEVANI POLICY, ICICI LOMBARD

Arogya Sanjeevani Policy, ICICI Lombard is an ideal choice if you are looking for a health plan that provides coverage for the basic health needs. It is a standard policy that will have your back in times of a medical emergency. You can also extend its benefits to your family (spouse, dependent parents and children). It covers you for pre and post hospitalisation expenses and room charges, doctor or special consultant’s fees, medicine bills during your hospitalisation for more 24 hours. Your day care procedures are also taken care of by this policy. Since the policy comes with plans that only differ with respect to sum insured and their respective premiums, having your pick becomes much easier. The sum insured begin just ₹1 Lakh onwards and you can choose plans up to ₹5 Lakh. Thus, this policy cuts down your confusion and keeps you well prepared for all the most basic health needs. You can avail cashless medical care, lifelong renewability benefit, cumulative bonus of 5% on sum insured, ambulance cover, In patient AYUSH Treatment (Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homeopathy), and dental and cataract treatment with it.

All the benefits mentioned here are indicative, for complete and detailed information on features, terms and conditions kindly read policy wordings carefully.

Explore our simple, hassle-free claims process

Cashless Claims

STEP 1

Get admitted in any of our network hospitals
- Empanelled list of Network Hospitals
STEP 2

Send us a fax of your pre-authorisation form and relevant documents
- Download pre-authorisation form
- View list of required documents
STEP 3

Our ICICI Lombard Health Care team reviews the claim and accepts, rejects or raises a query
STEP 4

Your claim is settled by the ICICI Lombard Health Care team
- View standard payments and exclusions
- Detailed claim process

Reimbursement Claims

STEP 1

Upon discharge, pay all hospital bills and collect all original documents of treatments and expenses undergone
STEP 2

Mail the duly filled (and signed by insured and treating doctor) claim form and required documents to your service provider (ICICI Lombard Health Care or TPA)
STEP 3

ICICI Lombard Health Care reviews your claim request and accordingly will approve, query or reject the same (as per policy terms and conditions)
STEP 4

ICICI Lombard Health Care settles the claim (as per policy terms and conditions) and reimburses the approved amount
- View standard payments and exclusions
- Detailed claim process

Other Third Party Administrator Claims – Cashless

STEP 1

Get admitted in any one of the TPAs network hospitals
- Empanelled list of Network Hospitals
STEP 2

Fax the pre-authorisation form along with relevant documents (Investigation reports, Previous consultation papers, Cashless ID, Photo ID)
- Download pre-authorisation forms
- View list of required documents
STEP 3

Your service provider reviews your claim request and accordingly will approve, query or reject the same
- View status descriptions
- Important dos and don'ts
STEP 4

Your service provider settles the claim (as per policy terms and conditions) with the hospital after completion of all formalities
- View standard payments and exclusions
- Detailed claim process

Other Third Party Administrator Claims – Reimbursement

STEP 1

Upon discharge, pay all hospital bills and collect all original documents of treatments and expenses undergone
STEP 2

Mail the duly filled (and signed by insured and treating doctor) claim form and required documents to your service provider (TPA)
STEP 3

Your service provider reviews your claim request and accordingly will approve, query or reject the same
STEP 4

Your service provider settles the claim (as per policy terms and conditions) and reimburses the approved amount
- View standard payments and exclusions
- Detailed claim process

NOTE

Cashless facility is only available at our cashless network hospitals

In case of planned hospitalisation, contact your service provider two days prior to admission

In case of emergency hospitalisation, contact your service provider within 24 hours of hospitalisation

For intimating the claim, please call our 24x7 toll free number 1800 2666 or SMS ‘HEALTHCLAIM’ to 575758 (charge – ₹ 3 per SMS) or email us at ihealthcare@icicilombard.com.

Please send the relevant documents to : ICICI Lombard Health Care, ICICI Bank tower, Plot No. 12, Financial District, Nanakramguda, Gachibowli, Hyderabad -500 032

GET ANSWERS TO COMMON QUERIES ABOUT AROGYA SANJEEVANI POLICY, ICICI LOMBARD

GENERAL
COVER
COVID19
PREMIUM
CLAIMS
POLICY

Does Arogya Sanjeevani Policy, ICICI Lombard cover COVID-19?

Yes, your hospitalisation expenses for COVID-19 are covered under Arogya Sanjeevani Policy, ICICI Lombard.

What’s the maximum age limit for Arogya Sanjeevani Policy, ICICI Lombard?

The maximum entry age limit is 65 years, and the minimum is 18 years. The minimum age for children is 91 days (floater option). Applicants who are more than 45 years of age will have to undergo a medical underwriting process.

Why do I need health insurance?

Health insurance protects you from the financial burden of unexpected, high medical costs. It covers medical expenses incurred during hospitalisation. It also provides the benefit of free health check-up and cashless hospitalisation.

How does it help to buy health insurance at a young age?

Buying health insurance at a young age is a prudent decision as it provides some significant benefits like an affordable premium, saving your tax and earning cumulative bonus.

How much health policy coverage do I need?

The amount of coverage needed is based on several deciding factors like current age, health conditions, family medical history, family members and their health conditions, ability to pay the premium and hospital preferences. You can consider these and then decide your coverage, or you can call us on 18002666 for assistance.

What coverage do I get with the Arogya Sanjeevani Policy, ICICI Lombard?

Hospitalisation, pre-hospitalisation and post-hospitalisation expenses are covered under Arogya Sanjeevani Policy, ICICI Lombard.

What is a family floater insurance?

Family floater insurance is a single health insurance policy that will cover one or more members of your family. They can be your legally wedded spouse, dependent parents and parents-in-law, and dependent children in the age group of 3 months to 25 years. It doesn’t cover children above 18 years of age who are financially independent.

How many new family members can I add to my current floater?

The floater option easily allows you to add up to 2 adults and 3 children (above 3 months of age) all under one policy. You can get your immediate family members covered (legally wedded spouse, dependent parents, parents-in-law and dependent children) for the same sum insured. If you want to add a new family member, you can do so only at the time of renewal.

Is overseas treatment for an illness covered?

The expenses for overseas treatments are not covered under Arogya Sanjeevani Policy, ICICI Lombard.

Will Arogya Sanjeevani Policy, ICICI Lombard pay for maternity expenses?

Maternity expenses like treatment of pregnancy and childbirth related complications are not covered under Arogya Sanjeevani Policy, ICICI Lombard.

Will Arogya Sanjeevani Policy, ICICI Lombard cover hospitalisation expenses for COVID-19?

Yes, hospitalisation expenses for COVID-19 will be covered under Arogya Sanjeevani Policy, ICICI Lombard as per the policy terms and conditions.

How can I intimate my claim for Arogya Sanjeevani Policy, ICICI Lombard after hospitalisation?

Claim intimation can be done online on IL Health Care or using our mobile app, IL Take Care. Scanned copies or photographs of all claim related documents can be uploaded in the app.
Further, the Insured is required to furnish/courier hard copies of all requisite claim documents at his/ her own expense to the below mentioned address:
ICICI Lombard Healthcare,
ICICI Bank Towers,
Plot No. 12, Financial district,
Nanakramguda, Gachibowli,
Hyderabad- 500032

Is any waiting period applicable under Arogya Sanjeevani Policy, ICICI Lombard for COVID-19 claim?

In case of a fresh policy, the hospitalisation expenses incurred for COVID-19 will be covered provided the illness is contracted after completion of 30 days. In case of a policy that has been renewed continuously without a break or in case of policies that have been ported in to ICICI Lombard, the 30 day condition will not be applicable.

Will the expenses towards COVID-19 vaccination be covered in case such vaccine is manufactured?

The expenses towards vaccination are not be covered under Arogya Sanjeevani Policy, ICICI Lombard.

Are the expenses on medicines and diagnostic tests incurred during medically advised home isolation due to COVID-19 covered?

No, Arogya Sanjeevani Policy, ICICI Lombard does not cover these expenses.

What is the starting premium for an adult under Arogya Sanjeevani Policy, ICICI Lombard?

The premium for Arogya Sanjeevani Policy, ICICI Lombard starts at ₹4025 for 1 Adult with ₹1 lakh sum insured.

How much premium qualifies for tax benefits?

Under section 80D of the Income Tax Act, you can avail tax benefits for premiums paid towards your health insurance policy. The following table explains total tax deduction for only assesse, spouse, dependent children and parents (whether dependent or not):

Description	Medical Insurance paid for self, spouse and dependent children (in ₹)	Medical Insurance paid for parents (whether dependent or not) (in ₹)	Total deduction under section 80D(in ₹)
All are under the age of 60 years	25,000	25,000	50,000
I. Assessee and family are under the age of 60 years II. Parents are above the age of 60 years	25,000	50,000	75,000
Assessee and parents have attained or are above the age of 60 years	50,000	50,000	1,00,000

Is the premium exempted from Income Tax?

Under section 80D of the Income Tax Act, 1961 you’re allowed to claim a deduction of ₹25,000 per year for the premium paid on health insurance of self, spouse, parents or children. The deduction allowed for senior citizens is ₹50,000.

Click here to know more about the tax benefits of health insurance .

What parameters are considered for calculating the premium?

Cover opted (Individual/Floater)
Age of senior-most member
Sum Insured selected

Is this product priced according to tier/location?

The premium for this product is not affected by the location of the policy holder.

Whom 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 to receive a call back. To avail cashless service use the health card at any network hospital.
For cashless emergency hospitalisation, we need to be contacted within 24 hours of hospitalisation.

Do I have to pay any amount while claiming under Arogya Sanjeevani Policy, ICICI Lombard?

Yes, 5% of the claim amount is to be paid by you as per the co-pay clause under Arogya Sanjeevani Policy, ICICI Lombard.

What do I do if my claim is rejected?

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

What is the Claim Settlement Ratio for ICICI Lombard Health Insurance?

Our claim settlement ratio for health is 99.8% (FY19).

What is the procedure for reimbursement settlement?

All the claims have to be intimated 48 hours prior to hospitalisation and within 24 hours post admission in case of emergency.

Intimate claim by sending SMS 'HEALTHCLAIM' to 575758 (charge – ₹3 per SMS) or calling our toll free number 1800 2666 or e-mail us at ihealthcare@icicilombard.com
Send your duly filled (and signed by you as well as your treating doctor) claim form and required documents to us
We will review your claim request (as per policy terms and conditions)
On approval, we will settle your claim (as per policy terms and conditions) and reimburse the approved amount to you

What are the sum insured options provided under Arogya Sanjeevani Policy, ICICI Lombard?

The annual sum insured options range between ₹1 lakh to ₹5 lakhs for Arogya Sanjeevani Policy, ICICI Lombard.

Can I get a higher sum insured under Arogya Sanjeevani Policy, ICICI Lombard?

If you need a policy with a sum insured higher than ₹5 lakhs then Arogya Sanjeevani Policy, ICICI Lombard is not the right pick for you. Explore our higher sum insured plans here.

What is the tenure for Arogya Sanjeevani Policy, ICICI Lombard?

Your health is covered for 1 year under Arogya Sanjeevani Policy, ICICI Lombard.

Do I need to undergo a pre-medical check-up while buying Arogya Sanjeevani Policy, ICICI Lombard?

No, you don’t have go for a pre-policy medical check-up if your age is below 45 years. However, a pre-policy medical check-up is compulsory if your age is 45 years or above. Your medical examination will be done at our designated diagnostic centres. We will return the cost incurred for the test in case your proposal for Arogya Sanjeevani Policy, ICICI Lombard is accepted.

Are all the major corporate hospitals on the network?

ICICI Lombard has tie-ups with over 6500+ leading hospitals across the country. This is to ensure the best service and round-the-clock assistance for our policyholders. Being in the network, these hospitals come with the cashless hospitalisation facility.

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