{"uin":"ICIHLIP23199V012223","name":"CIS Special Shield_ ICIHLIP23199V012223","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223","insurer":{"slug":"icici-lombard-general-insurance","name":"ICICI LOMBARD General Insurance Company Limited","url":"https://indiainsurances.com/insurer/icici-lombard-general-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"Special Shield is an individual indemnity health insurance policy for persons with disability and individuals with HIV/AIDS. It offers Rs. 4 lakh or Rs. 5 lakh sum insured, a 30 day initial illness waiting period, 36 months PED waiting period for pre-existing conditions other than disability and HIV/AIDS, and a 20% co-payment unless waived by paying additional premium.","analysis":{"state":"machine","analysed_at":"2026-10-20 04:27:42.29162+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"quote-verified","value":["Individual plan"],"display":"Only Individual plan is offered","note":null,"quote":"c) In given product only Individual plan is offered. Therefore, premium illustration of individual plan is shown only.","sources":[{"clause":"Annexure A","heading":null,"page":17,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/19959#c-annexure-a"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"One policy period is 1 Year.","display":"1 Year","note":null,"quote":"Policy Period | 1 Year","sources":[{"clause":"11","heading":"TABLE OF BENEFITS","page":32,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-11-3"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"quote-verified","value":"For emergency hospitalization, notice with full particulars must be sent within 24 hours from the date emergency hospitalization is required or before discharge, whichever is earlier. For planned hospitalization, notice must be sent at least 48 hours prior to admission.","display":"Emergency: within 24 hours or before discharge, whichever is earlier; planned: at least 48 hours before admission","note":null,"quote":"Notice with full particulars shall be sent to the Company/TPA (if applicable) as under:\ni) Within 24 hours from the date of emergency hospitalization required or before the Insured Person’s discharge from Hospital, whichever is earlier.\nii) At least 48 hours prior to admission in Hospital in case of a planned Hospitalization.","sources":[{"clause":"10.3","heading":"Notification of Claim","page":29,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-10-3-2"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"quote-verified","value":["Duly Completed claim form signed by You and the Medical Practitioner","Original bills, receipts and discharge certificate/ card from the Hospital/ Medical Practitioner","Original bills from chemists supported by proper prescription.","Original investigation test reports and payment receipts.","Indoor case papers","Medical Practitioner's referral letter advising Hospitalization in non-Accident cases.","Photo Identity proof of thepatient","Medical practitioner's prescription advising admission.","Original bills with itemized break-up","NEFT Details (to enable direct credit of claim amount in bank account) and cancelledcheque.","KYC (Identity proof with Address) of the proposer, where claim liability is above Rs 1 Lakhas per AML Guidelines"],"display":"Claim form, hospital bills and discharge card, chemist bills, test reports, indoor case papers, referral letter, photo ID, prescription, itemized bills, NEFT/cancelled cheque and KYC where applicable","note":null,"quote":"i) Duly Completed claim form signed by You and the Medical Practitioner. The claim form can be downloaded from our website www.icicilombard.com\nii) Original bills, receipts and discharge certificate/ card from the Hospital/ Medical Practitioner\niii) Original bills from chemists supported by proper prescription.\niv) Original investigation test reports and payment receipts.\nv) Indoor case papers\nvi) Medical Practitioner's referral letter advising Hospitalization in non-Accident cases. ... ix. Photo Identity proof of thepatient\nx. Medical practitioner's prescription advising admission.\nxi. Original bills with itemized break-up ... xviii. NEFT Details (to enable direct credit of claim amount in bank account) and cancelledcheque.\nxix. KYC (Identity proof with Address) of the proposer, where claim liability is above Rs 1 Lakhas per AML Guidelines","sources":[{"clause":"10.4","heading":"Documents to be submitted","page":29,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-10-4"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"quote-verified","value":"The company shall settle or reject a claim 15 days from receipt of claim along with claim form. If investigation is warranted, it must be completed not later than 30 days from receipt of the last necessary document and the claim settled or rejected within 45 days from receipt of the last necessary document, with interest at 2% above bank rate for delay.","display":"15 days from receipt of claim with claim form; investigation cases within 45 days from last necessary document","note":null,"quote":"i) The Company shall settle or reject a claim as the case may be 15 days from the date of receipt of claim along with claim form. ... iii) However, where the circumstances of a claim warrant an investigation in the opinion of the Company, it shall initiate and complete such investigation at the earliest, in any case not later than 30 days from the date of receipt of last necessary document- ln such cases, the Company shall settle or reject the claim within 45 days from the date of receipt of last necessary document. ... iv) ln case of delay beyond stipulated 45 days, the Company shall be liable to pay interest to the policyholder at a rate 2% above the bank rate from the date of receipt of last necessary document to the date of payment of claim.","sources":[{"clause":"3(i)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-3-i"},{"clause":"3(iii)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-3-iii"},{"clause":"3(iv)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-3-iv"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"quote-verified","value":"For grievances, the insured may first contact ICICI Lombard through its website, toll-free number, email, address or grievance cell at branches. If not satisfied, the insured may contact the grievance redressal officer, then IRDAI/Bima Bharosa or the Insurance Ombudsman.","display":"Contact ICICI Lombard first by website, 1800 2666, customersupport@icicilombard.com, address or branch grievance cell; then GRO, IRDAI/Bima Bharosa or Ombudsman","note":null,"quote":"ln case of any grievance the insured person may contact the Company through Website: www.icicilombard.com Toll free: 1800 2666 Email: customersupport@icicilombard.com ICICI Lombard General Insurance Co. Ltd. Ground floor- Interface 11, Sixth floor- Interface 16 , Office no 601 & 602, New linking Road, Malad (West), Mumbai – 400064 ... lnsured person may also approach the grievance cell at any of the company's branches with the details of grievance. ... lf lnsured person is not satisfied with the redressal of grievance, insured person may contact the grievance redressal officer at the details provided in the below link:\nhttps://www.icicilombard.com/grievanceredressal.com","sources":[{"clause":"15","heading":"Redressal of Grievance","page":26,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-15-2"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"quote-verified","value":"The available sum insured options are Rs. 4 lakh and Rs. 5 lakh on an individual basis.","display":"4lacs and 5 lacs","note":null,"quote":"Sum insured available(in INR) | 4lacs and 5 lacs","sources":[{"clause":"11","heading":"TABLE OF BENEFITS","page":32,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-11-3"}],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days for illness, except accident claims","note":"This exclusion does not apply if the insured person has continuous coverage for more than twelve months.","quote":"a) Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.","sources":[{"clause":"Excl03","heading":"First 30 days waiting period- Code- Excl03","page":17,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-excl03"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"quote-verified","value":{"unit":"months","amount":36},"display":"36 months for pre-existing conditions other than HIV/ AIDS and Disability","note":"Pre-existing disability has a 24 month waiting period; coverage after the waiting period is subject to the PED being declared and accepted.","quote":"a) Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 24 months for pre-existing disability/ 36 months for all pre-existing conditions other than HIV/ AIDS and Disability(as mentioned in Policy Schedule) of continuous coverage after the date of inception of the first policy with insurer.","sources":[{"clause":"Excl01(a)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-excl01-a"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"quote-verified","value":{"unit":"months","amount":24},"display":"24 months","note":"The exclusion is not applicable for claims arising due to an accident.","quote":"a) Expenses related to the treatment of the listed Conditions; surgeries/treatments shall be excluded until the expiry of 24 months as (mentioned in Policy Schedule) of continuous coverage after the date of inception of the first policy with us.","sources":[{"clause":"Excl02(a)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-excl02-a"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"quote-verified","value":["Benign ENT disorders","Tonsillectomy","Adenoidectomy","Mastoidectomy","Tympanoplasty","Hysterectomy","All internal and external benign tumors, cysts, 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 accident.","Calculi in urinary system, Gall Bladder and Bile duct, excluding malignancy.","Varicose Veins and Varicose Ulcers"],"display":"Benign ENT disorders; tonsillectomy; adenoidectomy; mastoidectomy; tympanoplasty; hysterectomy; benign tumors/cysts/polyps; benign prostate hypertrophy; cataract and age-related eye ailments; gastric/duodenal ulcer; gout and rheumatism; hernia; hydrocele; non-infective arthritis; piles/fissures/fistula; pilonidal sinus/sinusitis; spinal disc and spinal diseases; calculi; varicose veins/ulcers","note":null,"quote":"24 Months waiting period.\n1. Benign ENT disorders\n2. Tonsillectomy\n3. Adenoidectomy\n4. Mastoidectomy\n5. Tympanoplasty\n6. Hysterectomy\n7. All internal and external benign tumors, cysts, polyps of any kind, including benign breast lumps.\n8. Benign prostate hypertrophy\n9. Cataract and age-related eye ailments\n10. Gastric/ Duodenal Ulcer\n11. Gout and Rheumatism\n12. Hernia of all types\n13. Hydrocele\n14. Non-Infective Arthritis\n15. Piles, Fissures and Fistula in anus\n16. Pilonidal sinus, Sinusitis and related disorders\n17. Prolapse inter Vertebral Disc and Spinal Diseases unless arising from accident.\n18. Calculi in urinary system, Gall Bladder and Bile duct, excluding malignancy.\n19. Varicose Veins and Varicose Ulcers","sources":[{"clause":"Excl02(e)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-excl02-e"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"quote-verified","value":{"unit":"months","amount":60},"display":"sixty continuous months","note":"For enhanced sums insured, sixty continuous months applies from the date of enhancement only on the enhanced limits.","quote":"After completion of sixty continuous months of coverage (including portability and migration) in health insurance policy, no policy and claim shall be contestable by the insurer on grounds of non-disclosure, misrepresentation, except on grounds of established fraud. This period of sixty continuous months is called as moratorium period.","sources":[{"clause":"12","heading":"Moratorium Period","page":26,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-12-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"quote-verified","value":"The insured has the choice to port the policy from one insurer to another and transfer credits gained to the extent of the sum insured and benefits available in the previous policy, subject to the company's underwriting policy. This benefit is not applicable for enhanced sum insured.","display":"Can port to another insurer with waiting-period credit, subject to underwriting; not applicable for enhanced sum insured","note":null,"quote":"a) The insured has the choice to port his / her policies from one Insurer to another.\nb) The insured is entitled to transfer the credits gained to the extent of the sum insured and the benefits available in the previous policy, subject to the underwriting policy of the Company ... d) This benefit is not applicable for enhanced sum insured.","sources":[{"clause":null,"heading":"9. Portability","page":25,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-9-portability"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"quote-verified","value":true,"display":"Lifetime renewability: no maximum age limit for Renewal","note":"Stated in the prospectus.","quote":"Lifetime renewability: There is no maximum age limit for Renewal.","sources":[{"clause":"2","heading":"Lifetime renewability","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/19959#c-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"quote-verified","value":"The policy says the insurer will not apply any additional loading at renewal based on claim experience, and individual renewal loadings are at portfolio level and not based on any individual policy claim experience.","display":"No additional loading at renewal based on claim experience","note":"Risk-based loading applied at the first policy may continue at renewals, as stated in the prospectus.","quote":"We will not apply any additional loading at renewal based on claim experience. ... IV) No loading shall apply on renewals based on individual claims experience ... V) For individual products, the loadings on renewal premium shall be at portfolio and not based upon any individual policy claim experience.","sources":[{"clause":"15(d)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/19959#c-15-d"},{"clause":"15(IV)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/19959#c-15-iv"},{"clause":"15(V)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/19959#c-15-v"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"quote-verified","value":["Investigation & Evaluation- Code- Excl04","Rest Cure, rehabilitation, and respite care- Code- Excl05","Obesity/ Weight Control: Code- Excl06","Change-of-Gender treatments: Code- Excl07","Cosmetic or plastic Surgery: Code- Excl08","Hazardous or Adventure sports: Code- Excl09","Breach of law: Code- Excl10","Excluded Providers: Code- Excl11","Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code- Excl12","Treatments received in heath hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing home attached to such establishments or where admission is arranged wholly or partly for domestic reasons. Code- Excl13","Dietary supplements and substances that can be purchased without prescription, including but not limited to Vitamins, minerals and organic substances unless prescribed by a medical practitioner as part of hospitalization claim or day care procedure. Code- Excl14","Refractive Error: Code- Excl15","Unproven Treatments: Code- Excl16","Sterility and Infertility: Code- Excl17","Maternity: Code Excl18","Any medical treatment taken outside India.","Hospitalization for donation of any body organs by an Insured including complications arising from the donation of organs.","War, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, commotion, unrest, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalisation or requisition of or damage by or under the order of any government or public local authority.","Venereal/ Sexually Transmitted disease other than HIV/AIDS.","Stem cell storage."],"display":"Excl04 to Excl18 plus specific exclusions including treatment outside India, organ donor hospitalization, war, venereal/sexually transmitted disease other than HIV/AIDS, and stem cell storage","note":"Excl01 to Excl03 are waiting periods and are not listed here as permanent exclusions.","quote":"Excl04 Investigation & Evaluation- Code- Excl04 ... Excl05 Rest Cure, rehabilitation, and respite care- Code- Excl05 ... Excl06 Obesity/ Weight Control: Code- Excl06 ... Excl07 Change-of-Gender treatments: Code- Excl07 ... Excl08 Cosmetic or plastic Surgery: Code- Excl08 ... Excl09 Hazardous or Adventure sports: Code- Excl09 ... Excl10 Breach of law: Code- Excl10 ... Excl11 Excluded Providers: Code- Excl11 ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code- Excl12 ... Treatments received in heath hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing home attached to such establishments or where admission is arranged wholly or partly for domestic reasons. Code- Excl13 ... Dietary supplements and substances that can be purchased without prescription, including but not limited to Vitamins, minerals and organic substances unless prescribed by a medical practitioner as part of hospitalization claim or day care procedure. Code- Excl14 ... Refractive Error: Code- Excl15 ... Unproven Treatments: Code- Excl16 ... Sterility and Infertility: Code- Excl17 ... Maternity: Code Excl18 ... 1. Any medical treatment taken outside India.\n2. Hospitalization for donation of any body organs by an Insured including complications arising from the donation of organs. ... 4. War, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, commotion, unrest, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalisation or requisition of or damage by or under the order of any government or public local authority. ... 13. Venereal/ Sexually Transmitted disease other than HIV/AIDS.\n14. Stem cell storage.","sources":[{"clause":"Excl04","heading":"Investigation & Evaluation- Code- Excl04","page":18,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-excl04"},{"clause":"Excl05","heading":"Rest Cure, rehabilitation, and respite care- Code- Excl05","page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-excl05"},{"clause":"Excl06","heading":"Obesity/ Weight Control: Code- Excl06","page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-excl06"},{"clause":"Excl07","heading":"Change-of-Gender treatments: Code- Excl07","page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-excl07"},{"clause":"Excl08","heading":"Cosmetic or plastic Surgery: Code- Excl08","page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-excl08"},{"clause":"Excl09","heading":"Hazardous or Adventure sports: Code- Excl09","page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-excl09"},{"clause":"Excl10","heading":"Breach of law: Code- Excl10","page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-excl10"},{"clause":"Excl11","heading":"Excluded Providers: Code- Excl11","page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-excl11"},{"clause":"9","heading":null,"page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-9"},{"clause":"10","heading":null,"page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-10"},{"clause":"11","heading":null,"page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-11"},{"clause":"12","heading":"Refractive Error: Code- Excl15","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-12"},{"clause":"13","heading":"Unproven Treatments: Code- Excl16","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-13"},{"clause":"14","heading":"Sterility and Infertility: Code- Excl17","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-14"},{"clause":"15","heading":"Maternity: Code Excl18","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-15"},{"clause":null,"heading":"8.2 Specific Exclusions","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-8-2-specific-exclusions"},{"clause":"15(d)","heading":null,"page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-15-d"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"quote-verified","value":"The policyholder may cancel at any time during the term by giving 7 days’ notice in writing. For a term up to one year, the company refunds proportionate premium for the unexpired policy period if no claim has been made, but no refund is made where any claim has been admitted or lodged or any benefit has been availed.","display":"7 days’ written notice; proportionate premium for unexpired period if term is up to one year and no claim; no refund if any claim admitted, lodged or benefit availed","note":"Free-look cancellations follow the separate free-look clause.","quote":"The policyholder may cancel his/her policy at any time during the term, by giving 7 days’ notice in writing. ... i) Refund proportionate premium for unexpired policy period, if the term of policy up to one year and there is no claim (s) made during the policy period. ... Notwithstanding anything contained herein or otherwise, no refunds of premium shall be made in respect of Cancellation where, any claim has been admitted or has been lodged or any benefit has been availed by You under this Policy.","sources":[{"clause":"7","heading":"Cancellation","page":24,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-7-2"},{"clause":"7(i)","heading":null,"page":24,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-7-i"},{"clause":"7(ii)","heading":null,"page":24,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-7-ii"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"The policy does not cover medical treatment taken outside India, so medical treatment cover is India only.","display":"India only","note":null,"quote":"1. Any medical treatment taken outside India.","sources":[{"clause":null,"heading":"8.2 Specific Exclusions","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-8-2-specific-exclusions"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days beginning from the date of receipt of policy document","note":"Applies to new individual health insurance policies except those with tenure of less than a year.","quote":"Every insured of new individual health insurance policies, except for those policies with tenure of less than a year, shall be provided a free look period of 30 days beginning from the date of receipt of policy document, whether received electronically or otherwise, to review the terms and conditions of such policy.","sources":[{"clause":"14","heading":"Free Look Period","page":26,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-14-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"quote-verified","value":{"unit":"days","amount":15},"display":"fifteen days where premium payment mode is monthly and thirty days in all other cases","note":"The norm uses the monthly grace period; other payment modes have thirty days.","quote":"The grace period for payment of the premium for all types of insurance policies shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases.","sources":[{"clause":"11","heading":"Premium Payment in Instalments","page":25,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-11-2"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"conflicting","value":"The policy wording table states adult entry age is 18 years to 65 years and children are eligible from Newborn to 17 years.","display":"Adults: 18 years to 65 years; Children: Newborn to 17 years","note":"Prospectus says: \"Entry age: This Policy can be offered to children with minimum age of 3 months and maximum up to 17 years of age. Adults aged between 18 years and 65 years of age also can be insured.\"","quote":"Eligibility | Policy can be availed by availed on Individual basis. Age eligibility for adults: 18 years to 65 years Age eligibility for Children: Newborn to 17 years","sources":[{"clause":"11","heading":"TABLE OF BENEFITS","page":32,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-11-3"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["Half Yearly","Quarterly","Monthly"],"display":"Half Yearly, Quarterly or Monthly","note":null,"quote":"If the insured person has opted for Payment of Premium on an instalments basis i.e. Half Yearly, Quarterly or Monthly, as mentioned in Your Policy Schedule/Certificate of Insurance","sources":[{"clause":"11","heading":"Premium Payment in Instalments","page":25,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-11-2"}],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"quote-verified","value":["waiver for Co-pay"],"display":"Co-payment can be waived off by paying an additional premium","note":null,"quote":"Co-pay | 20% on all claims made under the policy unless waiver for Co-pay is opted and premium is paid for the same. ... This co-payment can be waived off by paying an additional premium (optional).","sources":[{"clause":"11","heading":"TABLE OF BENEFITS","page":32,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-11-3"},{"clause":"10.5","heading":"Co-Payment","page":31,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-10-5"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"For renewal after the policy period, coverage is not available during the grace period. The definition also says coverage shall be offered during the grace period if the premium is paid in instalments during the policy period.","display":"Renewal grace: coverage not available; instalment premium grace during policy period: coverage offered if paid in instalments","note":null,"quote":"At the end of the Policy Period, the policy shall terminate and can be renewed within the Grace Period to maintain continuity of benefits without Break in Policy. Coverage is not available during the grace period. ... Provided the insurers shall offer coverage during the grace period, if the premium is paid in instalments during the policy period.","sources":[{"clause":"10","heading":"Renewal of Policy","page":25,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-10-2"},{"clause":"3.1(vii)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349#c-3-1-vii"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. 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Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 2","url":"https://indiainsurances.com/law/irdai-health-mc-2024"}]},{"key":"organ_donor","label":"Organ donor expenses","section":"Cover","meaning":"Whether the donor's hospital costs for an organ transplant are paid.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"restoration","label":"Restoration of sum insured","section":"Cover","meaning":"Whether the sum insured is refilled after it is used up in a year, how much, how often, and whether it works for the same illness.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]}],"documents":[{"kind":"wording","label":"Special Shield","pages":50,"fetched_at":"2026-10-20 02:32:53+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/special-shield8c0007ff45fd68ff8a0df0055fa7634e.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20349"},{"kind":"wording","label":"Special Shield","pages":39,"fetched_at":"2026-10-20 02:47:49+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/special-shield8c0007ff45fd68ff8a0df0055fa76364.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20654"},{"kind":"prospectus","label":"Special Shield_Prospectus_ICIHLIP23199V012223","pages":17,"fetched_at":"2026-10-20 02:05:50+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/special-shield--prospectus.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/19959"},{"kind":"prospectus","label":"Special Shield_Prospectus_ICIHLIP23199V012223","pages":18,"fetched_at":"2026-10-20 02:37:18+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/prospectus-special-shield8c0007ff45fd68ff8a0df0055f9f127c.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/20384"},{"kind":"cis","label":"CIS Special Shield_ ICIHLIP23199V012223","pages":9,"fetched_at":"2026-10-20 01:52:15+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/special-shield-cis.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223/document/19791"}],"versions":[],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"ICICI LOMBARD General Insurance official website","url":"https://www.icicilombard.com","note":"Website as listed by IRDAI. Not checked: the site blocks automated requests (bot wall) for our crawler on 2026-10-19; we do not bypass walls."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"CIS Special Shield_ ICIHLIP23199V012223 (UIN ICIHLIP23199V012223), IndiaInsurances, https://indiainsurances.com/policy/icici-lombard-general-insurance/cis-special-shield-icihlip23199v012223-icihlip23199v012223"}