Personal Health

Insurance from ICICI LombardCall +91

9900113820 for more information

Who said I need health Insurance?

I don’t fall sick!! Why should I take an Health

Insurance??

Health insurance is needed more now than ever before because of -

Why Health Insurance?

Skyrocketing medical costs

Need for routine

medical check ups and care

Expensive trips to

specialist doctors

Possibility of hospitalization and treatment

Benefits of Health Insurance from ICICI Lombard

Pre-existing disease covered (after 2 years)

Day care surgeries / treatments

covered

Free yearly medical checkup coupons for up to

2 people

Cashless Treatment at

Specialty Hospitals

Optional Maternity cover

available

Outpatient treatment covered

Scope/ Coverage

What illness will you be covered for ?? And

what will you not be covered !

Scope of cover

Disease/ Injury Treated medically/

surgically By Hospitalisation/

Domiciliary hospitalisation

At Nursing home/ hospital in India as in-patient

Age limit 90 days – 80 years

Pre hospitalisation Relevant medical

expenses 30 days prior to hospitalisation

Post hospitalisation Relevant medical

expenses 60 days after hospitalisation

Compensation payable

Reasonable and necessarily incurred Room expenses in

hospital/ nursing home

Nursing expenses Medical

practitioner fee

Treatment costMedicines/ diagnostic

cost Blood/ oxygenCost of pacemakerOperation theatre

chargesSurgical appliancesDialysis,

chemotherapy, radiotherapy

Compensation payable contd.…

Pre and post hospitalisation expenses

Max of SI Surgical operation Manual operative

procedure for Deformity Defect correction Diagnosis cure Prolongation of life

Hospitalisation

Min period of 24 hrs Time limit not applicable for specific

treatment Dialysis Chemotherapy Tonsillectomy Day Care Cataract

Pre & post hospitalisation

Pre hospitalisation Relevant medical expenses 30 days prior

to hospitalisation Post hospitalisation

Relevant medical expenses 60 days after hospitalisation

Any one illness Continuous Period of Illness Relapse within 45 days of the earlier

treatment

Domiciliary hospitalization Treatment exceeding 3 days at

Residence Serious condition of patient

does not allow removal to hospital

Lack of accommodation in nursing home

Pre / post hospitalisation expenses not covered

Specified diseases excluded - Asthma/ Diabetes/ Dysentery/ Hypertension/ Flu/ Epilepsy/ Arthritis

My No Service Areas..

Ok.. Lot of things are covered…Is there

anything left that we don’t cover???

First year exclusions

CataractBenign prostratic hypertrophyHysterectomy for menonhargia or fibromyomaHernia/ hydroceleCongenital internal diseaseFistula in anus/ pilesSinusitis & related disorder

General exclusions

War/ war group Nuclear perils Plastic surgery Spectacles/ contact lens/

hearing aid Dental treatment Convalescence/ general

debility Sterility/ venereal

disease / circumcision Intentional self injury

General exclusions contd.…

Use of intoxicating drugs/ alcohol

Aids Diagnostic/ laboratory

expenses not consistent with treatment

Vitamins/ tonic inconsistent with treatment

Pregnancy Naturopathy

Mediclaim…No Money

What if you have an emergency. Can we

provide service without cash??

Cashless mediclaim

Claim handled by both ICICI Lombard Health care & Outside TPA depending upon Client

Planned treatment in notified hospital Inform TPA & get treatment post

approvalCashless / Hassle free claims

settlement Emergency – What to do???

Give TPA membership no Intimate TPA & approvalCashless / Hassle free claims

settlement

Reimbursement

Process of Reimbursement and claims is giving me

Nausea.. I think I am sick..

Reimbursement – mediclaim

Planned / Emergency treatment in non-notified hospital Notice to TPA & approved Submit

Duly completed claim form Bills, receipts and discharge

certificate/card from the Hospital

Bills from Chemists supported by proper prescription.

Test reports and payment receipts

Settlement within a week on complete submission

Thank you

Call +91 9900113820 for more information