The policy covers the following 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 to hospitalisation
• Medical expenses incurred 60 days post hospitalisation
• Named Day Care expenses incurred on advanced technological surgeries and procedures like Dialysis, Radiotherapy, and Chemotherapy, requiring less than 24 hours of hospitalisation.
• Pre-existing diseases can be covered after 4 continuous years^## of coverage with the Company
• Secures you and your family against terrorist activities
• This policy also covers you for hospitalisation^{^^} in case of Swine Flu / H1N1 influenza^^

a. The policy can be renewed under the prevailing Family Floater Health Insurance Plan or its nearest substitute approved by IRDA in the event that the plan has been discontinued.

b. Renewal Premium - Premium payable on renewal and on subsequent continuation of cover are subject to change with prior approval from IRDA.

c. Maximum Renewal Age - This policy can be renewed up to a maximum age of 70 years.

d. Floater Benefit - The floater benefit under this policy is available up to the age of 60 years. All the insured above age of 60 years will be renewed under an individual plan.

e. Grace Period - The Policy may be renewed by mutual consent and in such event the renewal premium shall be paid to the Company on or before the date of expiry of the Policy and in no case later than 15 days (Grace Period) from the expiry of the Policy. However, the Company shall not be liable for any claim for the period for which premium is not received by the Company.

f. Cumulative Bonus - An Additional Sum Insured of 5% would be provided on cumulative basis on each renewal up to a maximum of 50% in case there is no claim under the policy. However, 10% of the Sum Insured will be reduced from the accumulated Additional Sum Insured, in case there is a claim under the policy.

g. Sum Insured Enhancement - Sum Insured can be enhanced only upon renewal, subject to underwriters' approval.

h. Inclusion / Exclusion of Insured - This policy allows to include or exclude a member in the plan only at the time of renewal.

i. Loading in case of Claims - The renewal premium shall be calculated as per the age of the senior most insured member as covered under the policy. A loading may be charged on the premium in case there is a claim in the expiring policy. The loading of premium is calculated as per the following scale :

j. In case of claim not pertaining to chronic Illness

Claim Amount ()	Loading
0 - 25,000	Nil
25,001 - 50,000	10%
50,001 - 100,000	20%
100,001 - 200,000	50%
>200,000	75%

For subsequent renewals, there will be no loading unless there is a claim in any renewal policy.
ii. In case of claim pertaining to chronic illness like heart diseases, cancer, brain diseases, organ failure and cirrhosis of the liver, loading of 75% on the base premium will be applicable. The loading will be applicable for all subsequent renewals. If there are claims in the subsequent renewals , further loading of 75% would be applicable, subject to a maximum of 200% on the base premium.

The extent of loading thus derived would be applicable for all subsequent renewals. For the purpose of determination of loading on renewal policies, chronic ailments mean any condition or Illness which is normally prolonged or recurrent, including but not limited to heart diseases, cancer, brain diseases, organ failure and cirrhosis of the liver.

• The customer can buy the policy for any family^{^} members.
• 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.
• The policy cover is renewable till the age of 70 years
• Individual(s) proposed for Insurance whose age is 56 years and above have to undergo medical tests at ICICI Lombard designated diagnostic centers.
• 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.
  

• Instant policy: Digitally signed policy available 24X7 online, customer can take prints. The hard copy of the policy is couriered the same day (or next day if customer buys after 6 PM) and will reach him/her within 2-3 working days.
• EMI without any extra charges^#
• No Paperwork required

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 2 consecutive years, the above diseases/illness/ailments will be covered from the 3rd year. If these are Pre-existing diseases at the time of inception of the policy, the same will be covered from the 4th year onwards.

Permanent Exclusions

• Any internal congenital illness.
• 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.

* Only expenses relating to hospitalisation will be reimbursed as per the policy coverage.

Standard list of documents required:

1. Claim form duly filled & signed by the insured & doctor.
2. Original discharge card/ summary & final bill.
3. All investigation reports in originals.
4. All medicines /lab/ hospital bill in original.
5. All payments receipts in original and should be stamped.
6. Any other required documents depending upon the case.