{"uin":"ICIHLIP25035V082425","name":"IL Complete Health Insurance_Prospectus_ICIHLIP25035V082425","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425","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":"ICICI Lombard Complete Health Insurance is a health indemnity policy with one, two or three year policy terms, family floater availability, and annual sum insured from ₹ 3,00,000 to ₹ 3,00,00,000. It has a 30-day initial waiting period, 24-month PED and specified disease waiting periods, reset up to 100% of annual sum insured, and optional covers including maternity, OPD, claim protector and worldwide cover.","analysis":{"state":"machine","analysed_at":"2026-10-20 04:29:58.505943+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":"not-stated","value":null,"display":null,"note":"The documents refer to plan eligibility and plan offerings but do not list named base plan variants.","quote":null,"sources":[],"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 year, two years or three years.","display":"1 year, 2 years or 3 years","note":null,"quote":"Policy tenure: You can opt for a Policy with Policy period of one year or two years or three years","sources":[{"clause":null,"heading":"Salient features","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20216#c-salient-features"}],"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 cashless treatment, request pre-authorisation at least 48 hours before planned hospitalisation or within 24 hours of emergency hospitalisation. For reimbursement, notify the insurer or its in-house claim processing team immediately and in any event within 10 days of hospitalisation.","display":"Cashless: 48 hours before planned hospitalisation or within 24 hours of emergency hospitalisation; reimbursement: immediately and within 10 days of hospitalisation","note":null,"quote":"You must request pre-authorisation at least 48 hours before a planned Hospitalisation and in case of an emergency situation, within 24 hours of Hospitalisation. ... The above information needs to be provided to Us or Our In house claim processing team immediately and in any event within 10 days of Hospitalisation","sources":[{"clause":null,"heading":"Pre-authorization","page":28,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-pre-authorization"},{"clause":"Row 1(b)(i)","heading":null,"page":29,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-row-1-b-i"}],"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 Hospitalisation in non-Accident cases","Any other document as required by Us or Our In house claim processing team"],"display":"Claim form, original hospital bills and discharge card, chemist bills with prescription, investigation reports, indoor case papers, referral letter for non-accident hospitalisation, and any other required document","note":null,"quote":"a) Duly completed Claim form signed by You and the Medical Practitioner. The claim form can be downloaded from Our website www.icicilombard. com\nb) Original bills, receipts and discharge certificate/card from the Hospital/Medical Practitioner\nc) Original bills from chemists supported by proper prescription.\nd) Original investigation test reports and payment receipts.\ne) Indoor case papers\nf) Medical Practitioner’s referral letter advising Hospitalisation in non-Accident cases.\ng) Any other document as required by Us or Our In house claim processing team","sources":[{"clause":null,"heading":"2. CLAIM DOCUMENTS","page":29,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-2-claim-documents"}],"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 insurer shall settle or reject a claim within 15 days from receipt of claim along with claim form. If investigation is warranted, it must complete investigation within 30 days from the last necessary document and settle or reject within 45 days from the last necessary document, with interest at 2% above bank rate for delay.","display":"15 days from receipt of claim with claim form; if investigated, within 45 days from receipt of last necessary document","note":null,"quote":"The Company shall settle or reject a claim, as the case may be, within 15 days from the date of receipt of claim along with claim form. ... 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. ... 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","sources":[{"clause":"Excl03(i)(i)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-i-i"},{"clause":"Excl03(i)(iii)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-i-iii"},{"clause":"Excl03(i)(iv)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-i-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":"quote-verified","value":["Pre-Existing Diseases: excluded until 24 months","Specified Disease/Procedure waiting period: excluded until 24 months","30-day waiting period for any illness except accident","Investigation & Evaluation","Rest Cure, rehabilitation and respite care","Obesity/ Weight Control","Change of Gender treatments","Cosmetic or plastic Surgery","Hazardous or Adventure sports","Breach of law","Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof","Treatment taken outside the country, unless Worldwide Cover has been opted for","Intentional self-injury"],"display":"PED 24 months, specified disease/procedure 24 months, 30-day illness waiting, and exclusions including investigation/evaluation, rest cure, obesity/weight control, change of gender, cosmetic surgery, hazardous sports, breach of law, substance abuse, treatment outside India unless worldwide cover, and intentional self-injury","note":null,"quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with insurer. ... Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. ... 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. ... Code- Excl04: Investigation & Evaluation ... Code- Excl05: Exclusion Name: Rest Cure, rehabilitation and respite care ... Code- Excl06: Obesity/ Weight Control ... Code- Excl07: Change of Gender treatments ... Code- Excl08: Cosmetic or plastic Surgery ... Code- Excl09: Hazardous or Adventure sports ... Code- Excl10: Breach of law ... Code- Excl12: Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. ... i Treatment taken outside the country, unless Worldwide Cover has been opted for.\nj. Intentional self-injury (whether arising from an attempt to commit suicide or otherwise)","sources":[{"clause":"Excl01","heading":"Code- Excl01: Pre-Existing Diseases","page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl01"},{"clause":"Excl02(a)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl02-a"},{"clause":"Excl03","heading":"Code- Excl03: 30-day waiting period","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03"},{"clause":null,"heading":"5. Permanent Exclusions","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-5-permanent-exclusions"},{"clause":"Excl03(a)(iii)","heading":"Code- Excl06","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-a-iii"},{"clause":"Excl03(a)(iv)","heading":"Code- Excl07","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-a-iv"},{"clause":"Excl03(a)(v)","heading":"Code- Excl08","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-a-v"},{"clause":"Excl03(a)(vi)","heading":"Code- Excl09","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-a-vi"},{"clause":"Excl03(a)(vii)","heading":"Code- Excl10","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-a-vii"},{"clause":"Excl03(a)(ix)","heading":"Code- Excl12","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-a-ix"},{"clause":"Excl03(d)(ii)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-d-ii"}],"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":"First contact ICICI Lombard through its website, toll-free number, email, postal address, or branch grievance cell. If not satisfied, contact the grievance redressal officer, then IRDAI/Bima Bharosa or Insurance Ombudsman.","display":"Complain first to ICICI Lombard by website, 1800 2666, customersupport@icicilombard.com, address, branch grievance cell or grievance redressal officer","note":null,"quote":"15. Redressal of Grievances 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, ... 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","sources":[{"clause":null,"heading":"17. Zone based premium","page":24,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-17-zone-based-premium"},{"clause":null,"heading":"14. Possibility of Revision of Terms of the Policy","page":24,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-14-possibility-of-revision-of-terms-of-the-polic"}],"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":"Minimum Sum Insured is ₹ 3,00,000 and Maximum Sum Insured is ₹ 3,00,00,000.","display":"₹ 3,00,000 to ₹ 3,00,00,000","note":null,"quote":"Annual sum insured: This denotes the maximum amount of cover available to You for a Policy Period of one year. Minimum Sum Insured: ₹ 3,00,000 Maximum Sum Insured: ₹ 3,00,00,000","sources":[{"clause":null,"heading":"Salient features","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20216#c-salient-features"}],"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","note":"Does not apply to accident claims, provided they are covered.","quote":"Code- Excl03: 30-day waiting period ... 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":"Code- Excl03: 30-day waiting period","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#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":24},"display":"24 months","note":"Applies afresh to the extent of any sum insured enhancement; portability credit can reduce it.","quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with insurer.","sources":[{"clause":"Excl01","heading":"Code- Excl01: Pre-Existing Diseases","page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl01"}],"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":"Hypertension, Diabetes and Cardiac Conditions have a 90-day exclusion unless pre-existing and disclosed at underwriting.","quote":"Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. ... Expenses related to the treatment of the below mentioned illness within 90 days from the first policy commencement date shall be excluded unless they are pre-existing and disclosed at the time of underwriting","sources":[{"clause":"Excl02(a)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl02-a"},{"clause":"Excl02(e)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl02-e"}],"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":["Cataract","Benign Prostatic Hypertrophy","Myomectomy, Hysterectomy unless because of malignancy","All types of Hernia, Hydrocele","Fissures &/or Fistula in anus, hemorrhoids/ piles","Arthritis, gout, rheumatism and spinal disorders","Joint replacements unless due to accident","Sinusitis and related disorders","Stones in the urinary and billiary systems","Dilatation and curettage , Endometriosis","All types of Skin and internal tumors/ cysts/ nodules/ polyps of any kind including breast lumps unless malignant","Dialysis required for chronic renal failure","Surgery on tonsils, adenoids and sinuses","Gastric and Duodenal erosions & ulcers","Deviated Nasal Septum","Varicose Veins/ Varicose Ulcers","Hypertension","Diabetes","Cardiac Conditions"],"display":"Cataract; BPH; myomectomy/hysterectomy; hernia/hydrocele; fissures/fistula/piles; arthritis/gout/rheumatism/spinal disorders; joint replacements; sinusitis; urinary and biliary stones; D&C/endometriosis; skin/internal tumours/cysts/nodules/polyps; chronic renal failure dialysis; tonsils/adenoids/sinuses surgery; gastric and duodenal erosions and ulcers; DNS; varicose veins/ulcers; hypertension; diabetes; cardiac conditions","note":"The first list has 24 months; Hypertension, Diabetes and Cardiac Conditions have 90 days.","quote":"List of specific diseases/procedure:\n• Cataract*\n• Benign Prostatic Hypertrophy\n• Myomectomy, Hysterectomy unless because of malignancy\n• All types of Hernia, Hydrocele\n• Fissures &/or Fistula in anus, hemorrhoids/ piles\n• Arthritis, gout, rheumatism and spinal disorders\n• Joint replacements unless due to accident\n• Sinusitis and related disorders\n• Stones in the urinary and billiary systems\n• Dilatation and curettage , Endometriosis\n• All types of Skin and internal tumors/ cysts/ nodules/ polyps of any kind including breast lumps unless malignant\n• Dialysis required for chronic renal failure\n• Surgery on tonsils, adenoids and sinuses\n• Gastric and Duodenal erosions & ulcers\n• Deviated Nasal Septum\n• Varicose Veins/ Varicose Ulcers ... i) Hypertension\nii) Diabetes\niii) Cardiac Conditions","sources":[{"clause":"Excl02(e)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#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 sum insured, sixty continuous months applies from the enhancement date 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":null,"heading":"12. Moratorium Period","page":22,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-12-moratorium-period"}],"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":"You can port the policy from one insurer to another by applying at least 30 days before, but not earlier than 60 days from, the renewal due date, and transfer credits gained to the extent of sum insured and benefits available in the previous policy, subject to underwriting.","display":"Portability allowed with waiting-period credit, subject to underwriting","note":"Not applicable for enhanced sum insured.","quote":"The insured has the choice to port his / her policies from one Insurer to another. An Insured desirous of porting his/her policy to another insurer shall apply to such insurer to port the entire policy along with all the members of the family, if any, at least 30 days before, but not earlier than 60 days from the due date for renewal.\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","sources":[{"clause":null,"heading":"9. Portability","page":22,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#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":"Yes, lifetime renewability","note":null,"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/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20216#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":"No loading shall apply on renewals based on individual claims experience.","display":"No claim-based renewal loading","note":null,"quote":"No loading shall apply on renewals based on individual claims experience.","sources":[{"clause":null,"heading":"10. Renewal of Policy","page":22,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-10-renewal-of-policy"}],"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":["Excl04: Investigation & Evaluation","Excl05: Rest Cure, rehabilitation and respite care","Excl06: Obesity/ Weight Control","Excl07: Change of Gender treatments","Excl08: Cosmetic or plastic Surgery","Excl09: Hazardous or Adventure sports","Excl10: Breach of law","Excl11: Excluded Providers","Excl12: Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof","Excl13: Treatments received in heath hydros, nature cure clinics, spas or similar establishments","Excl14: Dietary supplements and substances that can be purchased without prescription","Excl15: Refractive Error","Excl16: Unproven Treatments","Excl17: Sterility and Infertility","Excl18: Maternity","Treatment taken outside the country, unless Worldwide Cover has been opted for","Intentional self-injury"],"display":"Standard permanent exclusions Excl04 to Excl18, plus product exclusions such as treatment outside India unless worldwide cover and intentional self-injury","note":"Excl18 is not applicable if Optional Maternity Cover has been opted for.","quote":"Code- Excl04: Investigation & Evaluation ... Code- Excl05: Exclusion Name: Rest Cure, rehabilitation and respite care ... Code- Excl06: Obesity/ Weight Control ... Code- Excl07: Change of Gender treatments ... Code- Excl08: Cosmetic or plastic Surgery ... Code- Excl09: Hazardous or Adventure sports ... Code- Excl10: Breach of law ... Code- Excl11: Excluded Providers ... Code- Excl12: Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. ... Code- Excl13: 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- Excl14: Dietary supplements and substances that can be purchased without prescription ... Code- Excl15: Refractive Error ... Code- Excl16: Unproven Treatments ... Code- Excl17: Sterility and Infertility ... Code- Excl18: Maternity: ... i Treatment taken outside the country, unless Worldwide Cover has been opted for.\nj. Intentional self-injury (whether arising from an attempt to commit suicide or otherwise)","sources":[{"clause":null,"heading":"5. Permanent Exclusions","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-5-permanent-exclusions"},{"clause":"Excl03(a)(iii)","heading":"Code- Excl06","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-a-iii"},{"clause":"Excl03(a)(iv)","heading":"Code- Excl07","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-a-iv"},{"clause":"Excl03(a)(v)","heading":"Code- Excl08","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-a-v"},{"clause":"Excl03(a)(vi)","heading":"Code- Excl09","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-a-vi"},{"clause":"Excl03(a)(vii)","heading":"Code- Excl10","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-a-vii"},{"clause":"Excl03(a)(viii)","heading":"Code- Excl11","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-a-viii"},{"clause":"Excl03(a)(ix)","heading":"Code- Excl12","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-a-ix"},{"clause":"Excl03(a)(x)","heading":"Code- Excl13","page":20,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-a-x"},{"clause":"Excl03(a)(xi)","heading":"Code- Excl14","page":21,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-a-xi"},{"clause":"Excl03(a)(xii)","heading":"Code- Excl15","page":21,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-a-xii"},{"clause":"Excl03(a)(xiii)","heading":"Code- Excl16","page":21,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-a-xiii"},{"clause":"Excl03(a)(xiv)","heading":"Code- Excl17","page":21,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-a-xiv"},{"clause":"Excl03(d)(ii)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-d-ii"}],"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":"You may cancel at any time during the term by giving 7 days' written notice. If the policy term is up to one year and no claim is made, the insurer refunds proportionate premium for the unexpired period; for terms over one year, it refunds premium for uncommenced policy years, but no refund is made where any claim has been admitted, lodged or any benefit availed.","display":"7 days' written notice; proportionate refund for unexpired period if term up to 1 year and no claim; for terms over 1 year, refund for uncommenced policy years","note":"Free-look cancellations use the free-look refund clause.","quote":"The insured may cancel the policy at any time during the term, by giving 7 days notice in writing. ... 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. ... Refund premium for the unexpired policy period, in respect of policies with term more than 1 year and risk coverage for such policy years has not commenced ... 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 the Insured person under the Policy.","sources":[{"clause":null,"heading":"7. Cancellation","page":22,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-7-cancellation"},{"clause":"Excl03(d)(i)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-d-i-2"},{"clause":"Excl03(d)(ii)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-d-ii-2"}],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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","note":"Applies to new individual health insurance policies except policies 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","sources":[{"clause":null,"heading":"14. Possibility of Revision of Terms of the Policy","page":24,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-14-possibility-of-revision-of-terms-of-the-polic"}],"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":"15 days for monthly mode; 30 days in all other cases","note":"Renewal clause also says the policy can be renewed within the Grace Period of 30 days to maintain continuity.","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":null,"heading":"13. Premium Payment in installments","page":24,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-13-premium-payment-in-installments"}],"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":"quote-verified","value":"Minimum entry age is 6 years for an individual policy, with no maximum entry age restriction. Children from 3 months to 5 years can be insured under a floater plan only.","display":"Minimum 6 years for individual; 3 months to 5 years only under floater; no maximum entry age","note":"Maximum age for dependent children under floater policy is 20 years.","quote":"Entry age: This Policy can be offered to an individual with minimum age of 6 years without any restriction on maximum entry age. Children between age of 3 months to 5 years can be insured under a floater plan only.","sources":[{"clause":"1","heading":"Entry age: This Policy can be offered to an individual with minimum age of 6 years","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20216#c-1"}],"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 instalments","note":"The documents state instalment modes; they do not expressly list 'yearly' as a premium payment mode.","quote":"lf the insured person has opted for Payment of Premium on an instalment basis i.e. Half Yearly, Quarterly or Monthly, as mentioned in the policy Schedule/Certificate of lnsurance","sources":[{"clause":null,"heading":"13. Premium Payment in installments","page":24,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-13-premium-payment-in-installments"}],"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":["Hospital Daily Cash","Convalescence Benefit","Nursing at Home post Hospitalisation","Compassionate Visit","Critical Illness","Personal Accident","BeFit","Outpatient Treatment","Maternity Cover","New Born Baby Cover","Voluntary Co-Payment","Super Loyalty Bonus","Sum Insured Protector","Claim Protector","Worldwide Cover"],"display":"Hospital Daily Cash; Convalescence Benefit; Nursing at Home post Hospitalisation; Compassionate Visit; Critical Illness; Personal Accident; BeFit; Outpatient Treatment; Maternity Cover; New Born Baby Cover; Voluntary Co-Payment; Super Loyalty Bonus; Sum Insured Protector; Claim Protector; Worldwide Cover","note":"Voluntary Co-Payment is listed as an optional cover but is against premium reduction rather than additional premium.","quote":"The Covers listed below shall be available to the Insured Person only if the additional premium has been received by Us(except Optional Cover 11. Voluntary co-payment) and the Optional Cover is specified to be in force for that Insured Person in the Policy Schedule. ... 1. Hospital Daily Cash ... 2. Convalescence Benefit ... 3. Nursing at Home post Hospitalisation ... 4. Compassionate Visit ... 5. Critical Illness ... 6. Personal Accident ... 7. BeFit ... 8. Outpatient Treatment ... 9. Maternity Cover ... 10. New Born Baby Cover ... 11. Voluntary Co-Payment ... 12. Super Loyalty Bonus ... 13. Sum Insured Protector ... 14. Claim Protector ... 15. Worldwide Cover","sources":[{"clause":null,"heading":"B. Optional Covers","page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-b-optional-covers"},{"clause":null,"heading":"1. Hospital Daily Cash","page":13,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-1-hospital-daily-cash"},{"clause":null,"heading":"2. Convalescence Benefit","page":13,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-2-convalescence-benefit"},{"clause":null,"heading":"3. Nursing at Home post Hospitalisation","page":13,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-3-nursing-at-home-post-hospitalisation"},{"clause":null,"heading":"4. Compassionate Visit","page":13,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-4-compassionate-visit"},{"clause":null,"heading":"5. Critical Illness","page":13,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-5-critical-illness"},{"clause":null,"heading":"6. Personal Accident","page":14,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-6-personal-accident"},{"clause":null,"heading":"7. BeFit","page":15,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-7-befit"},{"clause":null,"heading":"8. Outpatient Treatment","page":17,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-8-outpatient-treatment"},{"clause":null,"heading":"9. Maternity Cover","page":17,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-9-maternity-cover"},{"clause":null,"heading":"10. New Born Baby Cover","page":18,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-10-new-born-baby-cover"},{"clause":null,"heading":"13. Sum Insured Protector","page":18,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-13-sum-insured-protector"},{"clause":null,"heading":"12. Super Loyalty Bonus","page":18,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-12-super-loyalty-bonus"},{"clause":null,"heading":"15. Worldwide Cover","page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-15-worldwide-cover"}],"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":"Coverage is not available during the renewal grace period. If premium is paid in instalments during the policy period, the company shall offer coverage during the grace period.","display":"No coverage during renewal grace period; coverage offered for instalment premium grace period during the policy period","note":"The two statements appear in the same wording document and apply to different contexts: renewal grace period and instalment premium grace period.","quote":"Coverage is not available during the grace period. ... Provided the company shall offer coverage during the grace period, if the premium is paid in instalments during the policy period.","sources":[{"clause":null,"heading":"10. Renewal of Policy","page":22,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-10-renewal-of-policy"},{"clause":null,"heading":"13. Premium Payment in installments","page":24,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-13-premium-payment-in-installments"}],"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. If you take a costlier room, other bills can be cut in proportion.","status":"not-stated","value":null,"display":null,"note":"The wording says room rent charges are covered 'up to the limits as mentioned in the Policy Schedule', but the schedule or product benefit table with the actual limit is not provided.","quote":null,"sources":[],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"not-stated","value":null,"display":null,"note":"The wording points to the Policy Schedule/Product benefit table for the eligible room category or limit, but the actual category is not stated in the provided documents.","quote":null,"sources":[],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"not-stated","value":null,"display":null,"note":"The wording covers ICU charges but does not state a per-day ICU limit in the provided documents.","quote":null,"sources":[],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"quote-verified","value":"If admitted in a room category or limit higher than specified in the Policy Schedule/Product benefit table, the insured bears a rateable proportion of associated medical expenses. Proportionate deductions are not applicable for ICU charges and not applicable for hospitals or expenses without differential billing by room category.","display":"Yes, rateable proportion of associated medical expenses if a higher room category/limit is used; not for ICU charges","note":null,"quote":"If the Insured Person is admitted in a room category/limit that is higher than the one that is specified in the Policy Schedule/ Product benefit table of this policy, then the Insured Person shall bear a rateable proportion of the total Associated medical expenses ... Proportionate deductions are not applicable for ICU charges ... Proportionate deductions shall not be applicable for hospitals which do not follow differential billing","sources":[{"clause":"1(v)","heading":null,"page":4,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-1-v"},{"clause":"1(b)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-1-b"},{"clause":"1(c)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-1-c"}],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"not-stated","value":null,"display":null,"note":"The wording says the insurer will not be liable for any deductible amount if applicable and as defined in the Policy Schedule, but no deductible amount or basis is stated in the provided documents.","quote":null,"sources":[],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments (cataract, knee replacement...), even if the sum insured is higher.","status":"quote-verified","value":["Cataract treatment: up to 10% of the Annual Sum Insured subject to a maximum of Rs.1 Lakh per eye after two years"],"display":"Cataract: up to 10% of Annual Sum Insured, maximum Rs.1 Lakh per eye","note":null,"quote":"*After two years from the Period of Insurance Start Date, Our maximum liability arising out of any Claim for a cataract treatment shall be restricted to up to 10% of the Annual Sum Insured subject to a maximum of Rs.1 Lakh per eye.","sources":[{"clause":"Excl02(e)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl02-e"}],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days before admission that are paid if related to the hospitalisation.","status":"not-stated","value":null,"display":null,"note":"The wording covers pre-hospitalisation expenses up to limits specified in the Policy Schedule, but the number of days is not stated in the provided documents.","quote":null,"sources":[],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"not-stated","value":null,"display":null,"note":"The wording covers post-hospitalisation expenses up to limits specified in the Policy Schedule, but the number of days is not stated in the provided documents.","quote":null,"sources":[],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"quote-verified","value":"Domiciliary hospitalisation is covered if it continues for at least 3 consecutive days, with expenses payable from the first day. The policy excludes listed conditions such as asthma, arthritis, spinal ailments, liver disease, diabetes, epilepsy, hypertension and others under this cover.","display":"Covered if domiciliary hospitalisation continues at least 3 consecutive days","note":"Several illnesses are excluded from domiciliary hospitalisation, including asthma, arthritis, spine/disc ailments, liver disease, diabetes, epilepsy, hypertension and pyrexia.","quote":"We will cover the Medical Expenses incurred in respect of the Domiciliary Hospitalization of the Insured Person during the Policy Period provided that:\ni) The Domiciliary Hospitalization continues for at least 3 consecutive days in which case we will make payment under this Cover in respect of Medical Expenses incurred from the first day of Domiciliary Hospitalization.","sources":[{"clause":"11","heading":"Domiciliary Hospitalization","page":7,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-11"}],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"quote-verified","value":"In-patient AYUSH hospitalisation is covered up to the annual sum insured if treatment is at an AYUSH Hospital or AYUSH Day Care Centre, on reimbursement and/or cashless basis wherever applicable.","display":"Covered up to Annual Sum Insured in an AYUSH Hospital or AYUSH Day Care Centre","note":null,"quote":"We will cover medical expenses incurred in respect of Insured Person’s AYUSH Treatment during the Policy Period up to the Annual Sum Insured specified in the Policy Schedule provided that –\ni) The Insured person is Hospitalised for AYUSH Treatment at a AYUSH Hospital or AYUSH Day Care Centre.\nii) This Cover will be provided on reimbursement basis and/or on cashless basis wherever applicable","sources":[{"clause":"6","heading":"In Patient AYUSH Hospitalisation","page":6,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-6"}],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on 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":"quote-verified","value":"Organ donor in-patient hospitalisation expenses for harvesting the organ donated to the insured person are covered up to the annual sum insured, if the organ donation conforms to the Transplantation of Human Organs Act 1994 and the inpatient treatment claim of the insured person is accepted.","display":"Covered up to Annual Sum Insured for organ donor hospitalisation for harvesting","note":"Donor pre/post-hospitalisation, screening, organ acquisition, transportation or preservation and donor complications are excluded.","quote":"We will cover the medical expenses incurred in respect of an organ donor’s Hospitalization during the Policy Period for harvesting of the organ donated to the Insured Person up to the Annual Sum Insured specified in the Policy Schedule provided that:\ni) The organ donation confirms to the Transportation of Human Organs Act 1994 and the organ is used for the Insured Person\nii) We will cover only those Medical Expenses incurred in respect of an organ donor as an in-patient in the Hospital.","sources":[{"clause":"10","heading":"Donor Expenses","page":7,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-10"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Domestic road ambulance is covered for transfer to the nearest hospital, with reimbursement limited to 1% of annual sum insured up to Rs.10,000 per claim; if availed cashless, charges are covered as per actuals. Air ambulance is covered up to the annual sum insured for life-threatening emergency transport to the nearest hospital within India when road ambulance cannot be provided.","display":"Road ambulance: 1% of Annual Sum Insured, maximum Rs.10,000 on reimbursement, actuals on cashless; air ambulance: up to Annual Sum Insured","note":"Air ambulance excludes transportation outside India and is limited to the nearest hospital for emergency care.","quote":"Our maximum liability under this Benefit for every claim arising during the Policy Year will be restricted to 1% of the Annual Sum Insured maximum up to Rs.10,000 in case the charges of road ambulance are being reimbursed. In case the services of a health care or ambulance service provider are being availed on cashless basis, the charges of road ambulance will be covered as per actuals. ... We will cover the expenses incurred on Air Ambulance services up to the Annual Sum Insured","sources":[{"clause":"8","heading":"Domestic Road Ambulance","page":6,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-8"},{"clause":"9","heading":"Air Ambulance Cover","page":6,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-9"}],"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":"quote-verified","value":"The Reset Benefit resets up to 100% of annual sum insured once for the same illness/disease/injury and unlimited times for different illness/disease/injury for the same insured person in a policy year. It does not trigger for the first claim, total reset cannot exceed the annual sum insured, and it applies only to admissible inpatient or daycare claims.","display":"Reset up to 100% of Annual Sum Insured, once for same illness and unlimited times for different illness in a Policy Year","note":"Not available for illness/injury or related complications, including relapse within 45 days, for which a claim has been paid in that policy year for the same insured person.","quote":"We will reset up to 100% of the Annual Sum Insured, Once for same illness/disease/injury and Unlimited times for different illness/disease/injury for the same Insured Person in a Policy Year as stated in the Policy Schedule ... The Reset Benefit will not be triggered for the first claim made during the Policy Year ... The total amount of reset will not exceed the Annual Sum Insured for that Policy Year","sources":[{"clause":"7","heading":"Reset Benefit","page":6,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-7"}],"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":"quote-verified","value":"Loyalty Bonus of 20% of the lower of expiring or renewed annual sum insured is provided at the end of each policy year if the policy is continuously renewed with the company, up to 100% of annual sum insured. The credited Loyalty Bonus is not reduced if there is a claim.","display":"20% Loyalty Bonus each policy year, maximum 100% of Annual Sum Insured; not reduced after a claim","note":null,"quote":"We will provide a Loyalty Bonusof 20% of expiring or renewed Annual Sum Insured (whichever is lower) at the end of each Policy Year if the expiring Policy is continuously renewed with the Company. The Loyalty Bonuswill not be accumulated for more than 100% of the Annual Sum ... In the event of Claim, under the Policy during any subsequent Policy Year, the credited Loyalty Bonuswill not be reduced.","sources":[{"clause":"14","heading":"Loyalty Bonus","page":11,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-14"},{"clause":"14(ii)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-14-ii"}],"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":"quote-verified","value":"The base inpatient cover includes medicines, drugs and consumables other than excluded non-medical items. If optional Claim Protector is bought and an inpatient or daycare claim is accepted, non-payable items in the list of excluded items related to that claim become payable up to the annual sum insured.","display":"Base covers consumables except excluded non-medical items; optional Claim Protector can cover listed non-payables up to Annual Sum Insured","note":"Claim Protector is optional, not part of the base cover.","quote":"Anaesthesia, blood, oxygen, operation theatre charges, medicines, drugs and consumables (other than those specified in the list of excluded expenses (non-medical) in Annexure I; ... 14. Claim Protector If a claim has been accepted under the “Inpatient Treatment” or “Daycare Procedure/Treaments” Cover, the items which are included in the List of Excluded items in clause on. f (ii) 29 ( Please refer List I- Items for which coverage is not available in the Policy) , which are non – payable, to the particular claim, will become payable.","sources":[{"clause":"1(v)","heading":null,"page":4,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-1-v"},{"clause":null,"heading":"12. Super Loyalty Bonus","page":18,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-12-super-loyalty-bonus"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"quote-verified","value":"Maternity expenses are excluded under the base policy, except ectopic pregnancy. If Optional Maternity Cover is opted, medical expenses for delivery including caesarean section or lawful medical termination of pregnancy are covered up to the limits in the Policy Schedule after 36 months of continuous coverage, limited to 2 deliveries/terminations and available only under a family floater policy.","display":"Base: excluded; optional maternity cover after 36 months, up to Policy Schedule limit, limited to 2 deliveries/terminations","note":"Optional cover only; pre- and post-hospitalisation expenses are not covered under this cover, though pre-natal and post-natal limits may be specified in the schedule.","quote":"Code- Excl18: Maternity: ... Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalisation) except ectopic pregnancy. ... Note: This exclusion shall not be applicable in case Optional Maternity Cover has been opted for. ... We will cover the Medical Expenses incurred for delivery of a child, including a caesarian section, during Hospitalization or lawful medical termination of pregnancy during the Policy Year maximum up to the limits as specified in the Policy Schedule. ... The Optional Cover shall be limited to 2 deliveries/ ... after 36 months of continuous coverage have elapsed ... This Cover is available only under a family floater Policy","sources":[{"clause":"Excl03(a)(xiv)","heading":"Code- Excl17","page":21,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-a-xiv"},{"clause":"Excl03(d)(i)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-d-i"},{"clause":"Excl03(d)(ii)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-excl03-d-ii"},{"clause":null,"heading":"9. Maternity Cover","page":17,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-9-maternity-cover"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"New Born Baby Cover is optional and is provided only if Maternity Cover is applicable. It covers hospitalisation medical expenses of the newborn up to the limits in the Policy Schedule for a maximum period up to 90 days from the date of birth.","display":"Optional, only with Maternity Cover; up to Policy Schedule limit for 90 days from birth","note":"Optional cover only.","quote":"We will cover the Medical Expenses incurred by You on Hospitalization of a “New born Baby” during each Policy Year of Policy Period subject to the limits as specified in the Policy Schedule. This Optional Cover will be provided only if Maternity Cover is applicable to You. This Optional Cover will cover Medical Expenses incurred on the “New born Baby” during Hospitalization (for a minimum period of consecutive 24 hours) for a maximum period up to 90 days from the date of birth of the baby","sources":[{"clause":null,"heading":"10. New Born Baby Cover","page":18,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-10-new-born-baby-cover"}],"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":"The provided documents do not expressly state cover for in-patient treatment of mental illness.","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":"quote-verified","value":"Insured persons aged 21 years and above can avail a preventive health check-up as per eligibility under the opted plan, only at network providers or empaneled health service providers, once per policy year per insured person. A maximum of 2 preventive health check-up coupons are provided per policy year for a floater policy.","display":"Preventive health check-up once per Policy Year for age 21+, max 2 coupons per floater Policy Year","note":null,"quote":"Insured Person(s) aged 21 years and above can avail a Preventive Health Check-up as per eligibility under the plan opted only at our Network Providers or empaneled Health Service Providers anytime during the Policy Period subject to the below conditions\n• This Cover can be availed only on Cashless basis and is limited to once per Policy Year per Insured Person.\n• Maximum of 2 Preventive Health Check-up coupons shall be provided per Policy Year for a floater Policy","sources":[{"clause":"15","heading":"Preventive Health Check-up","page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-15"}],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"quote-verified","value":"Base OPD reimbursement is not stated as included. Optional Outpatient Treatment reimburses consultation charges, diagnostic tests and medicines up to the optional cover sum insured; Optional BeFit also offers OPD services on cashless basis via the mobile application.","display":"OPD reimbursement only as optional Outpatient Treatment; BeFit optional cashless OPD services","note":"Optional covers are not part of the base answer unless bought.","quote":"The Covers listed below shall be available to the Insured Person only if the additional premium has been received by Us ... 7. BeFit ... All benefits under the BeFit cover can be availed only on cashless basis via our mobile application ... 8. Outpatient Treatment ... We will cover You for the Medical Expenses incurred by You as an Out-patient subject to Sum Insured as mentioned against this Optional Cover under this Policy. ... Out-patient medical expenses would be restricted to the following\n• Consultation charges of the Medical Practitioner\n• Diagnostic tests as recommended by the Medical Practitioner for any Illness/ Injury sustained\n• Medicines are prescribed by the Medical Practitioner","sources":[{"clause":null,"heading":"B. Optional Covers","page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-b-optional-covers"},{"clause":null,"heading":"7. BeFit","page":15,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-7-befit"},{"clause":null,"heading":"8. Outpatient Treatment","page":17,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-8-outpatient-treatment"}],"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":"quote-verified","value":"Cashless treatment is available only at a network provider. For cashless facility, pre-authorisation must be requested, and the insurer says it will respond within 1 hour of receipt of the pre-authorisation request and grant final authorisation within three hours of receipt of discharge authorisation request.","display":"Cashless available at Network Providers; pre-authorisation response within 1 hour and final authorisation within three hours","note":null,"quote":"Cashless treatment is only available at a Network Provider (List of Network Providers is available at our website). ... If You notify pre-authorization request for cashless facility through any of Our empaneled network hospitals along with complete set of documents & information, We will respond within 1 hour of the actual receipt of such pre-authorization request. Further, we shall grant final authorization within three hours of the receipt of discharge authorization request from the hospital","sources":[{"clause":"Row 1(a)(i)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-row-1-a-i"},{"clause":null,"heading":"Pre-authorization","page":28,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-pre-authorization"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"quote-verified","value":"Claims are handled by the insurer or its in-house claim processing team.","display":"ICICI Lombard / Our in house claim processing team","note":null,"quote":"You shall give notice to Us or Our In house claim processing team by calling the toll free number 1800 2666 or emailing us at customersupport@ icicilombard.com","sources":[{"clause":"Row 1(b)(i)","heading":null,"page":29,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641#c-row-1-b-i"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"quote-verified","value":true,"display":"Yes, floater cover for immediate family under the same sum insured","note":"A maximum of 5 members can be added in a single policy.","quote":"You can avail a floater cover and get Your immediate family covered for the same sum insured under a single Policy by paying one premium amount.","sources":[{"clause":"3","heading":"Number of members","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20216#c-3"}],"law":[]}],"documents":[{"kind":"wording","label":"Complete Health Insurance","pages":32,"fetched_at":"2026-10-20 02:47:19+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/complete-health-insurance8c0007ff45fd68ff8a0df0055fa76178.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20641"},{"kind":"prospectus","label":"IL Complete Health Insurance_Prospectus_ICIHLIP25035V082425","pages":25,"fetched_at":"2026-10-20 02:24:21+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/chi_prospectus-sales-literature.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425/document/20216"}],"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":"IL Complete Health Insurance_Prospectus_ICIHLIP25035V082425 (UIN ICIHLIP25035V082425), IndiaInsurances, https://indiainsurances.com/policy/icici-lombard-general-insurance/il-complete-health-insurance-prospectus-icihlip25035v082425-icihlip25035v082425"}