{"uin":"ICIHLIP25043V052425","name":"Health AdvantEdge_ICIHLIP25043V052425","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425","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":"Health AdvantEdge is a health indemnity policy with individual and family floater options and policy terms of one, two or three years. It covers inpatient treatment, day care, 60 days pre-hospitalisation, 180 days post-hospitalisation, AYUSH, road and air ambulance, reset benefit and loyalty bonus, with optional covers such as maternity, BeFit, critical illness, personal accident, co-payment and deductible.","analysis":{"state":"machine","analysed_at":"2026-10-20 04:26:54.810153+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"quote-verified","value":["Apex Plus Plan","Royal Plus Plan"],"display":"Apex Plus Plan; Royal Plus Plan","note":"From lower-priority plan brochures.","quote":"Apex Plus Plan ... Royal Plus Plan","sources":[{"clause":null,"heading":"Apex Plus Plan","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/19842#c-apex-plus-plan"},{"clause":null,"heading":"Royal Plus Plan","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/19846#c-royal-plus-plan"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"One policy can run for 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":"Section 2","heading":"SALIENT FEATURES & BENEFITS","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20097#c-section-2"}],"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, pre-authorisation must be requested at least 48 hours before planned hospitalisation and within 24 hours of emergency hospitalisation. For reimbursement, claim information must be provided immediately and in any event within 10 days of hospitalisation.","display":"Cashless: 48 hours before planned hospitalisation or within 24 hours of emergency; reimbursement: immediately and within 10 days of hospitalisation","note":"Claim documents must be delivered within 30 days of discharge, or within 30 days from completion of the post-hospitalisation period for post-hospitalisation expenses.","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":73,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-pre-authorization"}],"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 to investigate the Claim or Our obligation to make payment for it"],"display":"Claim form, original hospital bills/receipts/discharge certificate, chemist bills with prescription, investigation reports and receipts, 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 to investigate the Claim or Our obligation to make payment for it","sources":[{"clause":null,"heading":"2. Claim Documents","page":75,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#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 company shall settle or reject a claim within 15 days from receipt of claim along with the claim form. If investigation is required, it must be completed not later than 30 days from receipt of the last necessary document, and the claim must be settled or rejected within 45 days from receipt of the last necessary document.","display":"15 days from receipt of claim with claim form; if investigated, 45 days from receipt of last necessary document","note":"Delay attracts interest at 2% above bank rate under the policy wording.","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 the 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. In such cases, the Company shall settle or reject the claim within 45 days from the date of receipt of last necessary document.","sources":[{"clause":null,"heading":"3. Claim Settlement (provision for Penal Interest)","page":63,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-3-claim-settlement-provision-for-penal-interest"},{"clause":"32(iii)","heading":null,"page":63,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-32-iii"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"quote-verified","value":"First contact ICICI Lombard through its website, toll-free number, email, address or the grievance cell at a branch. If not satisfied, contact the grievance officer, then IRDAI through Bima Bharosa or IGCC, and then the Insurance Ombudsman subject to jurisdiction.","display":"ICICI Lombard website/toll-free/email/address or branch grievance cell, then grievance officer, then IRDAI or Insurance Ombudsman","note":"The same clause also gives IRDAI and Ombudsman escalation routes.","quote":"In case of any grievance the insured person may contact the Company through\nWebsite: www.icicilombard.com Toll free number: 1800 2666 Email: customersupport@icicilombard.com Address- ICICI Lombard General Insurance Co. Ltd. Ground floor- Interface 11, Sixth floor- Interface 16, Office no 601 & 602, New linking Road, Malad (West), Mumbai – 400064 ... lf lnsured person is not satisfied with the redressal of grievance, insured person may contact the grievance officer at the details provided in the below link: https://www.icicilombard.com/grievanceredressal.com","sources":[{"clause":null,"heading":"15. Nomination","page":67,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-15-nomination"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"quote-verified","value":"The prospectus states a minimum sum insured of ₹3,00,000 and a maximum sum insured of ₹3,00,00,000. Lower-priority brochures list plan options of 5, 7.5, 10, 15, 20, 25, 50, 75, 100, 200 and 300 lakhs.","display":"₹3,00,000 to ₹3,00,00,000; brochures list 5, 7.5, 10, 15, 20, 25, 50, 75, 100, 200 and 300 lakhs","note":"The full option list is from the lower-priority Royal Plus brochure; the prospectus states only minimum and maximum.","quote":"Minimum Sum Insured: ₹3,00,000\n. Maximum Sum Insured: ₹ 3,00,00,000 ... Overall Sum Insured (SI) Rupees | 5, 7.5, 10, 15, 20, 25, 50, 75, 100, 200, 300 (in Lakhs)","sources":[{"clause":"Section 2","heading":"SALIENT FEATURES & BENEFITS","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20097#c-section-2"},{"clause":null,"heading":"ROYAL PLUS PLAN","page":5,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/19846#c-royal-plus-plan-2"}],"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 covered accident claims.","quote":"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":"Excl02(a)","heading":null,"page":58,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl02-a-3"}],"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":0},"display":"0 Months/24 months depending on plan opted","note":"Royal Plus brochure says PED Waiting Period is 0 days; Apex Plus brochure says 2 years.","quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 0 Months/24 months (depending on plan opted) of continuous coverage after the date of inception of the first policy with insurer as selected by the Insurer","sources":[{"clause":"Excl01","heading":"Pre-Existing Diseases - Code- Excl01","page":56,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#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":0},"display":"0 months/24months depending on plan opted","note":"The same clause says the exclusion is not applicable for accident claims.","quote":"Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 0 months/24months (depending on plan opted) of continuous coverage after the date of inception of the first policy with us.","sources":[{"clause":"Excl02(a)","heading":null,"page":57,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl02-a"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"quote-verified","value":["Any types of gastric or duodenal ulcers","Benign prostatic hypertrophy","All types of sinuses","Hemorrhoids","Dysfunctional uterine bleeding","Endometriosis","Stones in the urinary and biliary systems","Surgery on ears/tonsils/adenoids/ paranasal sinuses","Cataracts,","Hernia of all types and Hydrocele","Fistulae in anus","Fissure in anus","Fibromyoma","Hysterectomy","Surgery for any skin ailment","Surgery on all internal or external tumours/ cysts/ nodules/polyps of any kind including breast lumps with exception of Malignancy","Dialysis required for Chronic Renal Failure.","Joint Replacement Surgeries unless necessitated by Accident happening after the Policy risk inception date.","Dilatation and curettage","Varicose Veins and Varicose Ulcers","Non Infective Arthritis and other form arthritis","Gout and Rheumatism","Prolapse inter Vertebral Disc and Spinal Diseases including spondylitis/spondylosis unless arising from Accident"],"display":"Listed conditions include ulcers, BPH, sinuses, hemorrhoids, dysfunctional uterine bleeding, endometriosis, stones, ENT surgeries, cataracts, hernia/hydrocele, fistula/fissure, fibromyoma, hysterectomy, skin surgery, tumours/cysts/nodules/polyps, dialysis for chronic renal failure, joint replacement, D&C, varicose veins/ulcers, non-infective arthritis, gout/rheumatism and spinal diseases","note":null,"quote":"1. Any types of gastric or duodenal ulcers\n2. Benign prostatic hypertrophy\n3. All types of sinuses\n4. Hemorrhoids\n5. Dysfunctional uterine bleeding\n6. Endometriosis\n7. Stones in the urinary and biliary systems\n8. Surgery on ears/tonsils/adenoids/ paranasal sinuses\n9. Cataracts,\n10. Hernia of all types and Hydrocele\n11. Fistulae in anus\n12. Fissure in anus\n13. Fibromyoma\n14. Hysterectomy\n15. Surgery for any skin ailment\n16. Surgery on all internal or external tumours/ cysts/ nodules/polyps of any kind including breast lumps with exception of Malignancy\n17. Dialysis required for Chronic Renal Failure.\n18. Joint Replacement Surgeries unless necessitated by Accident happening after the Policy risk inception date.\n19. Dilatation and curettage\n20. Varicose Veins and Varicose Ulcers\n21. Non Infective Arthritis and other form arthritis\n22) Gout and Rheumatism\n23) Prolapse inter Vertebral Disc and Spinal Diseases including spondylitis/spondylosis unless arising from Accident","sources":[{"clause":"Excl02(f)","heading":null,"page":57,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl02-f"}],"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":"years","amount":5},"display":"five continuous years","note":"For enhanced sums insured, five continuous years apply from the date of enhancement only on the enhanced limits.","quote":"After completion of five continuous years 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 five continuous years is called as moratorium period.","sources":[{"clause":null,"heading":"13. Moratorium Period","page":66,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-13-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":"The insured can port the policy to another insurer by applying to the new insurer to port the entire policy with family members, if any, at least 30 days before and not earlier than 60 days from the renewal due date. Credits gained can be transferred to the extent of the sum insured and benefits available in the previous policy, subject to underwriting.","display":"Allowed; apply at least 30 days before and not earlier than 60 days from renewal due date; waiting-period credits transfer subject to underwriting","note":null,"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. ... 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":"32(a)","heading":null,"page":66,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-32-a-3"},{"clause":"32(b)","heading":null,"page":66,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-32-b-3"}],"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, no maximum age limit for Renewal","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/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20097#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 applies on renewals based on individual claims experience.","display":"No loading on renewals based on individual claims experience","note":null,"quote":"No loading shall apply on renewals based on individual claims experience","sources":[{"clause":"32(b)(iii)","heading":null,"page":65,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-32-b-iii"}],"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- Code- Excl04","Excl05 Rest Cure, rehabilitation and respite care- Code- Excl05","Excl06 Obesity/ Weight Control: Code- Excl06","Excl07 Change-of-Gender treatments: Code- Excl07","Excl08 Cosmetic or plastic Surgery: Code- Excl08","Excl09 Hazardous or Adventure sports: Code- Excl09","Excl10 Breach of law: Code- Excl10","Excl11 Excluded providers: Code- Excl 11","Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code- Excl 12","Treatments received in heath hydros, nature cure clinics, spas or similar establishments","Dietary supplements and substances that can be purchased without prescription","Excl15 Refractive Error: Code- Excl15","Excl16 Unproven Treatments: Code- Excl 16","Excl17 Sterility and lnfertility: Code- Excl 17","Excl18 Maternity: Code Excl18","War (whether declared or not) and war like occurrence","Nuclear, chemical or biological attack or weapons","Any expenses incurred on Out Patient treatment","Treatment taken outside the geographical limits of India","Intentional self-injury (whether arising from an attempt to commit suicide or otherwise)"],"display":"Permanent exclusions include Excl04 to Excl18 and specific exclusions such as war, nuclear/chemical/biological attack, OPD unless BeFit, treatment outside India unless SI is Rs. 25 lakhs and above, and intentional self-injury","note":"Excl18 is modified if the maternity optional cover is opted; OPD exclusion is modified if BeFit is opted; treatment outside India exclusion does not apply for policies with Annual Sum Insured Rs. 25 lakhs and above.","quote":"Excl04 Investigation & Evaluation- Code- Excl04 ... Excl05 Rest Cure, rehabilitation and respite care- Code- Excl05 ... Excl06 Obesity/ Weight Control: Code- Excl06 ... Excl07 Change-of-Gender treatments: Code- Excl07 ... Excl08 Cosmetic or plastic Surgery: Code- Excl08 ... Excl09 Hazardous or Adventure sports: Code- Excl09 ... Excl10 Breach of law: Code- Excl10 ... Excl11 Excluded providers: Code- Excl 11 ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code- Excl 12 ... Treatments received in heath hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing home attached to such establishments ... Dietary supplements and substances that can be purchased without prescription ... Excl15 Refractive Error: Code- Excl15 ... Excl16 Unproven Treatments: Code- Excl 16 ... Excl17 Sterility and lnfertility: Code- Excl 17 ... Maternity: Code Excl18 ... War (whether declared or not) and war like occurrence or invasion ... Nuclear, chemical or biological attack or weapons ... Any expenses incurred on Out Patient treatment. This exclusion will not be applicable in case optional cover 8. BeFit has been opted ... Treatment taken outside the geographical limits of India. This exclusion shall not be applicable for policies with Annual Sum Insured Rs. 25 lakhs and above ... Intentional self-injury (whether arising from an attempt to commit suicide or otherwise)","sources":[{"clause":"Excl04","heading":"Investigation & Evaluation- Code- Excl04","page":58,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl04"},{"clause":"Excl05","heading":"Rest Cure, rehabilitation and respite care- Code- Excl05","page":58,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl05"},{"clause":"Excl06","heading":"Obesity/ Weight Control: Code- Excl06","page":59,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl06"},{"clause":"Excl07","heading":"Change-of-Gender treatments: Code- Excl07","page":59,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl07"},{"clause":"Excl08","heading":"Cosmetic or plastic Surgery: Code- Excl08","page":59,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl08"},{"clause":"Excl09","heading":"Hazardous or Adventure sports: Code- Excl09","page":59,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl09"},{"clause":"Excl10","heading":"Breach of law: Code- Excl10","page":59,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl10"},{"clause":"Excl11","heading":"Excluded providers: Code- Excl 11","page":60,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl11"},{"clause":"Excl12","heading":"Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof.","page":60,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl12"},{"clause":"Excl15","heading":"Refractive Error: Code- Excl15","page":60,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl15"},{"clause":"Excl16","heading":"Unproven Treatments: Code- Excl 16","page":60,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl16"},{"clause":"Excl17","heading":"Sterility and lnfertility: Code- Excl 17","page":60,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl17"},{"clause":"Excl18","heading":"Maternity: Code Excl18","page":61,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl18"},{"clause":"Excl18(ii)","heading":null,"page":61,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl18-ii"},{"clause":"Excl18(c)","heading":"Biological attack or weapons","page":61,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl18-c"},{"clause":"25","heading":null,"page":62,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-25"},{"clause":"31","heading":"Intentional self-injury (whether arising from an attempt to commit suicide or otherwise)","page":62,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-31"}],"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":"conflicting","value":"Under the policy wording, the policyholder may cancel by giving 7 days’ written notice. For terms up to one year, proportionate premium for the unexpired period is refunded if no claim has been made; for terms over one year, premium for unexpired policy years whose risk coverage has not commenced is refunded. No refund is made where any claim has been admitted or lodged or any benefit availed.","display":"7 days’ written notice; proportionate/unexpired premium refund if eligible; no refund if a claim is admitted, lodged or any benefit availed","note":"Prospectus says: “The Policyholder may cancel this Policy by giving 15days' written notice” and gives a percentage refund table.","quote":"The policyholder may cancel this policy by giving 7 days’ written notice and in such an event, the Company shall refund premium for the unexpired policy period as detailed below. ... Refund proportionate premium for unexpired policy period, if the term of policy up to one year and there is no claim\n(s) made during the policy period. ... Notwithstanding anything contained herein or otherwise, no refunds of premium shall be made in respect of Cancellation where, any claim has been admitted or has been lodged or any benefit has been availed by the insured person under the policy.","sources":[{"clause":"32(a)","heading":null,"page":64,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-32-a-2"},{"clause":"32(a)(i)","heading":null,"page":64,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-32-a-i"},{"clause":"32(a)(ii)","heading":null,"page":64,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-32-a-ii"},{"clause":null,"heading":"Terms of Renewal","page":27,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20097#c-terms-of-renewal"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"Medical treatment must be taken in India only, except that worldwide treatment is available for policies with Annual Sum Insured INR25 Lakh and above.","display":"India only; worldwide treatment for Annual Sum Insured INR25 Lakh and above","note":null,"quote":"All medical treatment for the purpose of this insurance will have to be taken in India only. For policies with Annual Sum Insured INR25 Lakh and above, Worldwide treatment will be available.","sources":[{"clause":null,"heading":"22. Territorial Limit","page":69,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-22-territorial-limit"}],"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":"conflicting","value":{"unit":"days","amount":30},"display":"30 days","note":"Prospectus says: “The insured person shall be allowed free look period of fifteen days (thirty days in case of distance marketing)”.","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":"5. Multiple policies","page":64,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-5-multiple-policies"},{"clause":"32(V)","heading":null,"page":30,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20097#c-32-v"}],"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 premium payment mode and 30 days in all other cases","note":"Renewal at the end of the policy period can be made 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":"Health AdvantEdge Policy Wordings","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-health-advantedge-policy-wordings"}],"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 and maximum entry age is 65 years. Children aged 91 days to 5 years can be insured only under a floater plan, and the maximum age for dependent children under a floater policy is 25 years.","display":"6 years to 65 years; children 91 days to 5 years only under floater; dependent children up to 25 years under floater","note":null,"quote":"Entry age: This Policy can be offered to an individual with minimum age of 6 years and maximum age of 65 years. Children between ages of 91 days to 5 years can be insured only under a floater plan only. Maximum age for dependent children under Floater Policy is 25 years.","sources":[{"clause":"1","heading":"Entry age","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20097#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","note":"Annual payment is not expressly listed in the quoted instalment clause.","quote":"If the insured person has opted for Payment of Premium on an installment basis i.e. Half Yearly, Quarterly or Monthly, as mentioned in Your Policy Schedule/certificate of insurance","sources":[{"clause":"32(b)(iii)","heading":null,"page":65,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-32-b-iii"}],"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":["Maternity Cover","New Born Baby Cover","Vaccinations for new born baby in the first year","Critical Illness","Personal Accident","Nursing at Home","Compassionate Visit","BeFit","Claim Protector","Sum Insured Protector","Voluntary Co-Payment","Voluntary Deductible","Worldwide Cover","Preventive Health Check-up (Reimbursement)","Room Rent Capping"],"display":"Maternity, newborn baby, newborn vaccinations, critical illness, personal accident, nursing at home, compassionate visit, BeFit, claim protector, sum insured protector, voluntary co-payment, voluntary deductible, worldwide cover, preventive health check-up reimbursement and room rent capping","note":"The wording says these apply only if additional premium is received, except voluntary co-payment and voluntary deductible.","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 12. Voluntary Deductible) ... 1. Maternity Cover ... 2. New Born Baby Cover ... 3. Vaccinations for new born baby in the first year ... 4. Critical Illness ... 5. Personal Accident ... 6. Nursing at Home ... 7. Compassionate Visit ... 8. BeFit ... 9. Claim Protector ... 10. Sum Insured Protector ... 11. Voluntary Co-Payment ... 12. Voluntary Deductible ... 13. Worldwide Cover ... 14. Preventive Health Check-up (Reimbursement) ... 15. Room Rent Capping","sources":[{"clause":"22","heading":"Incentives associated with vaccination against pneumococcal disease","page":35,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-22"},{"clause":null,"heading":"1. Maternity Cover","page":36,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-1-maternity-cover"},{"clause":null,"heading":"2. New Born Baby Cover","page":37,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-2-new-born-baby-cover"},{"clause":null,"heading":"3. Vaccinations for new born baby in the first year","page":38,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-3-vaccinations-for-new-born-baby-in-the-first-ye"},{"clause":null,"heading":"4. Critical Illness","page":38,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-4-critical-illness"},{"clause":null,"heading":"5. Personal Accident","page":44,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-5-personal-accident"},{"clause":null,"heading":"6. Nursing at Home","page":47,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-6-nursing-at-home"},{"clause":null,"heading":"7. Compassionate Visit","page":47,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-7-compassionate-visit"},{"clause":null,"heading":"8. BeFit","page":48,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-8-befit"},{"clause":null,"heading":"Claim Procedure for BeFit","page":51,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-claim-procedure-for-befit"},{"clause":null,"heading":"10. Sum Insured Protector","page":53,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-10-sum-insured-protector"},{"clause":null,"heading":"11. Voluntary Co-Payment","page":54,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-11-voluntary-co-payment"},{"clause":null,"heading":"12. Voluntary Deductible","page":54,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-12-voluntary-deductible"},{"clause":null,"heading":"13. Worldwide Cover","page":55,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-13-worldwide-cover"},{"clause":null,"heading":"14. Preventive Health Check-up (Reimbursement)","page":56,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-14-preventive-health-check-up-reimbursement"},{"clause":null,"heading":"15. Room Rent Capping","page":56,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-15-room-rent-capping"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"For renewal at the end of the policy period, coverage is not available during the grace period. For instalment premiums during the policy period, the wording states that insurers shall offer coverage during the grace period if the premium is paid in instalments during the policy period.","display":"Renewal grace period: no coverage; instalment premium grace period: coverage offered if premium is paid in instalments during the policy period","note":null,"quote":"Coverage is not available during the grace period. ... Provided the insurers shall offer coverage during the grace period, if the premium is paid in instalments during the policy period.","sources":[{"clause":"32(b)(iii)","heading":null,"page":65,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-32-b-iii"}],"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":"quote-verified","value":"For Annual Sum Insured up to Rs. 4 Lakhs, room rent is capped at 1% of Annual Sum Insured. For Annual Sum Insured Rs. 5 Lakhs and above, the base wording says there is no room rent capping, but the Room Rent Capping optional cover can cap Rs. 5 Lakhs to Rs. 20 Lakhs policies to a Single Private AC Room.","display":"Up to Rs. 4 Lakhs: 1% of Annual Sum Insured; Rs. 5 Lakhs and above: no room rent capping, unless Room Rent Capping cover applies","note":"CIS/brochures for Royal Plus/Apex Plus describe Single Private AC Room/Single private room up to Rs. 20 Lakhs and no capping at higher sums insured, while the main wording presents this as Room Rent Capping cover.","quote":"For policies with Annual Sum Insured options up to Rs. 4 Lakhs- room rent charges shall be capped at 1 % of Annual Sum Insured ... For policies with Annual Sum Insured options Rs. 5 Lakhs and above, there will be no room rent capping. ... For policies Annual Sum Insured options Rs. 5 Lakhs to Rs. 20 Lakhs – room rent charges shall be capped to a Single Private AC Room","sources":[{"clause":"1(a)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-1-a"},{"clause":"1(b)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-1-b"},{"clause":null,"heading":"15. Room Rent Capping","page":56,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-15-room-rent-capping"}],"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":"quote-verified","value":"Where the Room Rent Capping cover applies, Annual Sum Insured options Rs. 5 Lakhs to Rs. 20 Lakhs are capped to a Single Private AC Room.","display":"Single Private AC Room for Annual Sum Insured Rs. 5 Lakhs to Rs. 20 Lakhs where room rent capping applies","note":"The base wording separately says no room rent capping for Annual Sum Insured Rs. 5 Lakhs and above unless the Room Rent Capping cover applies.","quote":"For policies Annual Sum Insured options Rs. 5 Lakhs to Rs. 20 Lakhs – room rent charges shall be capped to a Single Private AC Room","sources":[{"clause":null,"heading":"15. Room Rent Capping","page":56,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-15-room-rent-capping"}],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"quote-verified","value":"For Annual Sum Insured up to Rs. 4 Lakhs, ICU charges are capped at 2% of Annual Sum Insured. For Annual Sum Insured Rs. 5 Lakhs and above, there is no capping on ICU charges.","display":"Up to Rs. 4 Lakhs: 2% of Annual Sum Insured; Rs. 5 Lakhs and above: no ICU capping","note":null,"quote":"For policies with annual sum insured options up to Rs. 4 Lakhs – intensive care unit charges shall be capped at 2% of Annual Sum Insured ... For policies with annual sum insured options Rs. 5 Lakhs and above- there shall be no capping on intensive care unit charges","sources":[{"clause":"1(a)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-1-a-2"},{"clause":"1(b)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-1-b-2"}],"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 the insured person is admitted in a higher room category or limit than specified, they bear a rateable proportion of associated medical expenses in the proportion of the difference between entitled room rent and actual room rent. Proportionate deductions are not applicable for ICU charges and do not apply where hospitals do not follow differential billing or to expenses without differential billing by room category.","display":"Yes, associated medical expenses are reduced rateably if a higher room is used; not applicable 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(b)(i)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-1-b-i"},{"clause":"1(b)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-1-b-3"},{"clause":"1(c)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#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":"quote-verified","value":"There is no stated compulsory co-payment in the base wording. The insured may opt for a Voluntary Co-payment, in which case the insured bears the specified co-payment percentage of each and every admissible claim amount; the CIS lists voluntary co-payment options of 10% or 20%.","display":"None unless Voluntary Co-payment is opted; options 10%/20%","note":"Voluntary co-payment is not applicable to add-ons/optional covers and cannot be opted with voluntary deductible.","quote":"In case Voluntary Co-payment is opted as mentioned in the Policy Schedule, the Insured Person will be liable to bear the specified Co-payment percentage of admissible claim amount of each and every claim amount. ... Voluntary Co-Payment opted-10%/20%","sources":[{"clause":null,"heading":"11. Voluntary Co-Payment","page":54,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-11-voluntary-co-payment"},{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":6,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20249#c-icici-lombard-general-insurance-company-limited-6"}],"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":"quote-verified","value":"There is no stated compulsory deductible in the base wording. The insured may opt for a Voluntary Deductible, which applies on an aggregate basis for all hospitalisation expenses during the policy year under the basic cover; the CIS lists options of Rs. 25,000, 50,000, 75,000 and 1,00,000.","display":"None unless Voluntary Deductible is opted; aggregate basis; Rs. 25,000/50,000/75,000/1,00,000","note":"Voluntary deductible is not available for Sum Insured 25 Lakhs and above and cannot be opted with voluntary co-payment.","quote":"In case Voluntary Deductible is opted as mentioned in the Policy Schedule, the Insured Person will be liable to bear the specified Deductible amount.\ni. Voluntary Deductible will apply on aggregate basis for all hospitalisation expenses during the policy year which fall under basic cover. ... Voluntary Deductible opted- Rs. 25,000/50,000/75,000/1,00,000","sources":[{"clause":null,"heading":"12. Voluntary Deductible","page":54,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-12-voluntary-deductible"},{"clause":null,"heading":"ICICI Lombard General Insurance Company Limited","page":6,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20249#c-icici-lombard-general-insurance-company-limited-6"}],"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":"not-stated","value":null,"display":null,"note":"No cataract, knee replacement or similar named disease/procedure rupee sub-limit was found in the policy wording; listed financial limits are for covers such as ambulance, home care and preventive check-up.","quote":null,"sources":[],"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":"quote-verified","value":{"unit":"days","amount":60},"display":"60 days before Admission","note":"Payable where the inpatient/day care/AYUSH hospitalisation claim is accepted; nursing care at home is excluded from pre-hospitalisation expenses.","quote":"We will cover the Pre-hospitalization Medical Expenses incurred in respect of the Insured Person immediately 60 days before the Insured Person’s Admission to Hospital","sources":[{"clause":"4","heading":"Pre- Hospitalisation Medical Expenses","page":15,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-4"}],"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":"quote-verified","value":{"unit":"days","amount":180},"display":"180 days following discharge","note":"Payable where the inpatient/day care/AYUSH hospitalisation claim is accepted; nursing care at home is excluded from post-hospitalisation expenses.","quote":"We will cover the Post-hospitalization Medical Expenses incurred in respect of the Insured Person immediately 180 days following the Insured Person’s discharge from Hospital","sources":[{"clause":"5","heading":"Post Hospitalization Medical Expenses","page":15,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-5"}],"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":"quote-verified","value":"Day Care Treatment is covered up to the Annual Sum Insured where treatment requires inpatient hospitalisation for less than 24 hours in a hospital. The cover includes but is not limited to intravenous chemotherapy, radiotherapy, hemodialysis or any other therapeutic procedure requiring specialised observation or care after completion, and excludes outpatient treatment and diagnostic services.","display":"Covered up to Annual Sum Insured; includes but not limited to IV chemotherapy, radiotherapy, hemodialysis and other therapeutic procedures; OPD/diagnostics excluded","note":null,"quote":"We will cover the Medical Expenses incurred in respect of the Day Care Treatment of the Insured Person during the Policy Period up to the Annual Sum Insured ... Day Care treatment requires hospitalization as an inpatient for less than 24 hours in a Hospital. ... including but not limited to intravenous chemotherapy, radiotherapy, hemodialysis or any other therapeutic procedure","sources":[{"clause":"2","heading":"Day Care Procedures/Treatment","page":13,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-2"}],"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 where it starts on written advice of a medical practitioner and continues for at least 3 consecutive days, with payment from the first day. Several conditions such as asthma, arthritis, spine/disc ailments, liver disease, diabetes, epilepsy, hypertension and pyrexia of any origin are excluded from this cover.","display":"Covered if advised in writing and continues for at least 3 consecutive days","note":"The clause lists exclusions for domiciliary hospitalisation, including asthma, arthritis, spine/disc ailments, chronic nephritis, liver disease, peptic ulcer, diarrhoea/dysentery/gastroenteritis, 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 the Domiciliary Hospitalization has commenced on the written advice of a medical practitioner and continues for at least 3 consecutive days","sources":[{"clause":"12","heading":"Domiciliary Hospitalization","page":19,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-12"}],"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 when the insured is hospitalised for AYUSH treatment at an AYUSH Hospital or AYUSH Day Care Centre.","display":"Covered up to Annual Sum Insured at 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 Hospitalized for AYUSH Treatment at a AYUSH Hospital or AYUSH Day Care Centre.","sources":[{"clause":"6","heading":"In Patient AYUSH Hospitalization","page":15,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#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":"quote-verified","value":"Technological advancements and treatments are covered up to the Annual Sum Insured. Listed treatments include uterine artery embolization and HIFU, immunotherapy, green/holmium laser prostate vaporisation, hematopoietic stem cell therapy for bone marrow transplant, balloon sinuplasty, oral chemotherapy, robotic surgeries, stereotactic radio surgeries, deep brain stimulation, intra vitreal injections, bronchial thermoplasty and IONM.","display":"Covered up to Annual Sum Insured for listed modern treatments including robotic surgeries, oral chemotherapy, immunotherapy and stem cell therapy","note":null,"quote":"We will cover the Medical Expenses incurred in respect of Hospitalization of the Insured Person for the below mentioned Technological Advancements and Treatments during the Policy Period, up to the Annual Sum Insured.\nSr. No | Treatment/Procedure\n1 | Uterine Artery Embolization and HIFU (High intensity focused ultrasound)\n2 | Immunotherapy- Monoclonal Antibody to be given as injection\n3 | Vaporisation of the prostrate (Green laser treatment or holmium laser treatment)\n4 | Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions\n5 | Balloon Sinuplasty\n6 | Oral Chemotherapy\n7 | Robotic surgeries\n8 | Stereotactic radio Surgeries\n9 | Deep Brain stimulation\n10 | Intra Vitreal injections\n11 | Bronchical Thermoplasty\n12 | IONM - (Intra Operative Neuro Monitoring)","sources":[{"clause":"3","heading":"Technological Advancements and Treatments","page":14,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-3"}],"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":"The policy covers an organ donor’s inpatient hospitalisation expenses for harvesting the organ donated to the insured person, up to the Annual Sum Insured, if the organ donation conforms to the Transplantation of Human Organs Act 1994 and the insured person’s inpatient treatment claim is accepted. It excludes donor pre/post hospitalisation, screening, acquisition, transportation/preservation and donor complications.","display":"Covered up to Annual Sum Insured for organ donor inpatient harvesting expenses","note":"Only donor inpatient expenses are covered; the clause excludes donor pre/post hospitalisation, screening and other listed donor-related expenses.","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 Transplantation of Human Organs Act 1994","sources":[{"clause":"11","heading":"Donor Expenses","page":18,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-11"}],"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 emergency facilities; reimbursement is limited to 1% of Annual Sum Insured up to INR 10,000 per claim, while cashless ambulance service is covered as per actuals. Domestic 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 up to INR 10,000 on reimbursement, actuals on cashless; air ambulance: up to Annual Sum Insured","note":"Road and air ambulance claims require an accepted inpatient claim for the same accident/illness.","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 INR 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 domestic 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":"9(i)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-9-i"},{"clause":"10","heading":"Domestic Air Ambulance Cover","page":18,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-10"}],"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 the Annual Sum Insured in a policy year. It triggers once for Annual Sum Insured below Rs. 10 Lakhs and unlimited times for Annual Sum Insured Rs. 10 Lakhs and above, but not for the first claim and not for an 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.","display":"Up to 100% reset; once below Rs. 10 Lakhs, unlimited at Rs. 10 Lakhs and above; not first claim; not same illness/relapse within 45 days","note":null,"quote":"We will reset up to 100% of the Annual Sum Insured, for any illness/disease/injury for the Insured Person in a Policy Year ... For policies with annual sum insured less than Rs. 10 Lakhs reset benefit will be triggered only once ... For policies with annual sum insured Rs. 10 Lakhs and above reset benefit will be triggered unlimited times ... The Reset Benefit will not be triggered for the first claim made during the Policy Year ... The Reset Benefit will not be available for an Illness /Injury or related complications including but not limited to any relapse within 45 days","sources":[{"clause":"8","heading":"Reset Benefit","page":16,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-8"}],"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":"The policy provides a Loyalty bonus of 20% of expiring or renewed Annual Sum Insured, whichever is lower, at the end of each policy year irrespective of a claim, subject to a maximum of 100% of Annual Sum Insured. Credited loyalty bonus is not reduced if there is a claim.","display":"20% each policy year, maximum 100%, irrespective of claim; not reduced on claim","note":"Called Loyalty bonus in the policy wording.","quote":"We will provide a Loyalty bonus of 20% of expiring or renewed Annual Sum Insured (whichever is lower) at the end of each Policy Year irrespective of a claim being initiated in the Policy Year ... The Loyalty bonus will not be accumulated for more than 100% of the Annual Sum Insured ... In the event of Claim, under the Policy during any subsequent Policy Year, the credited Loyalty bonus will not be reduced.","sources":[{"clause":"17","heading":"Loyalty bonus","page":31,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-17"},{"clause":"17(x)","heading":null,"page":32,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-17-x"}],"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 pays medicines, drugs and consumables other than items in Annexure II’s excluded non-medical list. If the Claim Protector optional cover applies and an inpatient or day care claim is accepted, the non-payable List I items related to that claim become payable up to the policy Sum Insured.","display":"Base covers consumables except Annexure II non-medical items; Claim Protector can make List I non-payables payable up to Sum Insured","note":"Claim Protector is an optional cover, though CIS/brochures say it is inbuilt for some higher sum insured options.","quote":"medicines, drugs and consumables (other than those specified in the list of excluded expenses (non-medical) in Annexure II. ... If a claim has been accepted under the “Inpatient Treatment” or “Daycare Procedure/Treaments” Cover, the items which are included in the List I- Items for which coverage is not available in the Policy of Annexure II, which are non – payable, to the particular claim, will become payable.","sources":[{"clause":"1(b)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-1-b-2"},{"clause":null,"heading":"Claim Procedure for BeFit","page":51,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-claim-procedure-for-befit"}],"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 unless the Maternity Cover optional cover is opted. Maternity Benefit A covers up to 10% of Annual Sum Insured subject to a maximum of INR 1 Lakhs with a 24-month waiting period; Maternity Benefit B covers up to 10% of Annual Sum Insured subject to a maximum of INR 10 Lakhs with a 9-month waiting period.","display":"Excluded unless optional cover is opted; A: 10% of ASI up to INR 1 Lakhs after 24 months; B: 10% of ASI up to INR 10 Lakhs after 9 months","note":"Both maternity benefit options are for female insured persons aged 18 to 45 years and are not available for Annual Sum Insured 3 and 4 Lakhs.","quote":"Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; ... This exclusion will stand modified to the effect to cover not be applicable in case optional cover 1 Maternity Cover- a) Maternity Benefit_A or b) Maternity benefit_B has been opted. ... This optional benefit covers the medical expenses up to 10% of the Annual Sum Insured; subject to a maximum limit of INR 1 Lakhs ... This benefit will have a waiting period of 24 months ... subject to a maximum limit of INR 10 Lakhs ... The benefit will have a waiting period of 9 months","sources":[{"clause":"Excl18(i)","heading":null,"page":61,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl18-i"},{"clause":"Excl18(ii)","heading":null,"page":61,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl18-ii"},{"clause":"22(a)(i)","heading":null,"page":36,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-22-a-i"},{"clause":"22(a)(iii)","heading":null,"page":36,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-22-a-iii"},{"clause":"22(b)(i)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-22-b-i"},{"clause":"22(b)(iii)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-22-b-iii"}],"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 an optional cover available only if Maternity Cover is opted and the insurer has accepted a maternity claim. It covers newborn hospitalisation expenses for up to 90 days from birth, with a maximum limit of twice the maternity sum insured.","display":"Optional; newborn hospitalisation up to 90 days from birth, up to twice the maternity sum insured","note":null,"quote":"We will cover the Medical Expenses incurred by the Insured Person on Hospitalization of a “New born Baby” during each Policy Year of Policy Period subject to the maximum limit of twice of the maternity sum Insured. ... This add on/ Optional Cover will be provided only if You have opted for the Maternity Cover and We have accepted a claim under Maternity cover under this policy. ... for a maximum period up to 90 days from the date of birth of the baby","sources":[{"clause":null,"heading":"2. New Born Baby Cover","page":37,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-2-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 documents do not state a specific inpatient mental illness cover; e-counselling appears under the optional BeFit cover.","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":"Adult insured persons aged 18 years and above can avail a preventive health check-up up to 0.5% of Annual Sum Insured, subject to a maximum of INR 10,000 per policy, with network or empanelled providers. It can be availed once per policy year per adult insured person.","display":"Once per policy year; up to 0.5% of Annual Sum Insured, maximum INR 10,000 per policy, for adults aged 18 years and above","note":null,"quote":"Adult Insured Person(s) aged 18 years and above can avail a Preventive Health Check-up up to 0.5% of Annual Sum Insured subject to a maximum of INR 10,000 per policy with our Network Providers or empaneled Health Service Providers anytime during the Policy Period ... Preventive health check-up can be availed only once per Policy Year per Adult Insured Person.","sources":[{"clause":"20","heading":"Preventive Health Check-up (Cashless)","page":34,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-20"}],"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 outpatient treatment is excluded except for specified benefits such as animal bite vaccination and tele-consultations. If the BeFit optional cover is opted, it covers outpatient physical consultations, routine diagnostics and minor procedures, pharmacy, physiotherapy, e-counselling and diet and nutrition e-consultation on a cashless basis through the mobile application, subject to limits in the policy schedule.","display":"Base OPD excluded; BeFit optional OPD cover available on cashless basis","note":"BeFit is an optional cover and cannot be used to answer base OPD limits unless opted.","quote":"Any expenses incurred on Out Patient treatment. This exclusion will not be applicable in case optional cover 8. BeFit has been opted ... All benefits under the BeFit cover can be availed only on cashless basis via our mobile application ... Physical Consultations ... Routine Diagnostic and Minor Procedure Cover ... Pharmacy ... Physiotherapy Session ... e-Counseling ... Diet and Nutrition e-Consultation","sources":[{"clause":"Excl18(c)","heading":"Biological attack or weapons","page":61,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-excl18-c"},{"clause":null,"heading":"8. BeFit","page":48,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-8-befit"},{"clause":"22(V)(c)(i)","heading":null,"page":48,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-22-v-c-i"},{"clause":"22(V)(c)(ii)","heading":null,"page":48,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-22-v-c-ii"},{"clause":"22(V)(c)(iii)","heading":null,"page":50,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-22-v-c-iii"},{"clause":"22(V)(c)(iv)","heading":null,"page":50,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-22-v-c-iv"},{"clause":"22(V)(c)(v)","heading":null,"page":50,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-22-v-c-v"},{"clause":"22(V)(c)(vi)","heading":null,"page":51,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-22-v-c-vi"}],"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":"quote-verified","value":"Premium depends on the insured person’s city of residence and pincode. The wording divides the country into Zone A, Zone B, Zone C and Zone D for premium computation.","display":"Premium depends on city of residence and pincode; Zones A, B, C and D","note":"The policy wording states zone-based premium, not a zone-based co-pay.","quote":"For the purpose of premium computation, the country has been divided into 4 zones. ... The premium will depend on the city of residence and pincode of the insured person.","sources":[{"clause":null,"heading":"18. Zone based premium","page":68,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-18-zone-based-premium"}],"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, and the insurer pays approved treatment costs directly to the network provider to the extent of pre-authorisation approval. The cashless procedure requires contacting the company or in-house claim processing team and requesting pre-authorisation.","display":"Available at Network Providers subject to pre-authorisation","note":null,"quote":"Cashless treatment is only available at a Network Provider (List of Network Providers is available at our website). ... Cashless facility\" means a facility extended by the Insurer to the Insured where, the payments of the costs of treatment undergone by the Insured in accordance with the Policy terms and conditions are directly made to the network provider by the Insurer to the extent pre-authorization approved.","sources":[{"clause":null,"heading":"1. Claims Procedure","page":72,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-1-claims-procedure"},{"clause":null,"heading":"Health AdvantEdge Policy Wordings","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-health-advantedge-policy-wordings"}],"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 company or its in-house claim processing team.","display":"Company or in house claim processing team","note":"The wording defines TPA generally, but the claim procedure refers to the company or its in-house claim processing team.","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":null,"heading":"Pre-authorization","page":73,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427#c-pre-authorization"}],"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 available for immediate family under one sum insured","note":null,"quote":"Floater policy: 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":"Floater policy","page":1,"url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20097#c-3"}],"law":[]}],"documents":[{"kind":"wording","label":"Health AdvantEdge_ICIHLIP25043V052425","pages":91,"fetched_at":"2026-10-20 02:39:25+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/health-advantedge8c0007ff45fd68ff8a0df0055fa75f89.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20427"},{"kind":"prospectus","label":"Health AdvantEdge_ICIHLIP25043V052425","pages":33,"fetched_at":"2026-10-20 02:16:33+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/ha_prospectus_website1---copy.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20097"},{"kind":"cis","label":"HealthAdvantEdge_CIS Royal Plus","pages":12,"fetched_at":"2026-10-20 02:27:01+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/hap-royal-plus-cis_-icihlip25043v052425.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/20249"},{"kind":"brochure","label":"Health Advantage (Apex Plus Plan) - ICIHLIP25043V052425","pages":8,"fetched_at":"2026-10-20 01:55:33+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/health-advantedge-apex-plus-plan-brochure.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/19842"},{"kind":"brochure","label":"Health Advantedge (Royal Plus plan)","pages":8,"fetched_at":"2026-10-20 01:55:49+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/health-advantedge-brochure_royal-plus-plan.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/19846"},{"kind":"premium","label":"Health AdvantEdge_ICIHLIP25043V052425","pages":null,"fetched_at":"2026-10-20 02:04:32+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/health-advantedge_rate-chart8c0007ff45fd68ff8a0df0055fa339c9.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/19635"},{"kind":"proposal","label":"Health AdvantEdge_ICIHLIP25043V052425","pages":null,"fetched_at":"2026-10-20 02:20:19+00","source_url":"https://www.icicilombard.com/docs/default-source/default-document-library/health-advantedge-_proposal-form---copy.pdf","url":"https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425/document/19671"}],"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":"Health AdvantEdge_ICIHLIP25043V052425 (UIN ICIHLIP25043V052425), IndiaInsurances, https://indiainsurances.com/policy/icici-lombard-general-insurance/health-advantedge-icihlip25043v052425-icihlip25043v052425"}